Provider Demographics
NPI:1235619479
Name:MAXEM HEALTH URGENT CARE MCCOMB
Entity Type:Organization
Organization Name:MAXEM HEALTH URGENT CARE MCCOMB
Other - Org Name:MCCOMB URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-319-5068
Mailing Address - Street 1:PO BOX 1248
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39566-1248
Mailing Address - Country:US
Mailing Address - Phone:707-319-5068
Mailing Address - Fax:228-382-9224
Practice Address - Street 1:101 EDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:MCCOMB
Practice Address - State:MS
Practice Address - Zip Code:39648-2043
Practice Address - Country:US
Practice Address - Phone:228-223-1927
Practice Address - Fax:228-382-9224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care