Provider Demographics
NPI:1295186286
Name:URGENT CARE MEDICAL CENTER LLC
Entity Type:Organization
Organization Name:URGENT CARE MEDICAL CENTER LLC
Other - Org Name:PRIORITY URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAKSH
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMPAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-268-7495
Mailing Address - Street 1:45 BRADFORD WALK
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-4530
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:105 WEST RD
Practice Address - Street 2:
Practice Address - City:ELLINGTON
Practice Address - State:CT
Practice Address - Zip Code:06029-5700
Practice Address - Country:US
Practice Address - Phone:860-268-7495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-30
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care