Provider Demographics
NPI:1275898975
Name:SAINT MARYS URGENT CARE LLC
Entity Type:Organization
Organization Name:SAINT MARYS URGENT CARE LLC
Other - Org Name:SAINT MARY'S URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DEPUTY GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:RADHA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SAVITALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-235-4308
Mailing Address - Street 1:411 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-4415
Mailing Address - Country:US
Mailing Address - Phone:775-770-7348
Mailing Address - Fax:775-770-7368
Practice Address - Street 1:18653 WEDGE PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-3323
Practice Address - Country:US
Practice Address - Phone:775-770-7664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-09
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty