Provider Demographics
NPI:1326354440
Name:TROYER URGENT CARE, INC.
Entity Type:Organization
Organization Name:TROYER URGENT CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDAL
Authorized Official - Middle Name:L
Authorized Official - Last Name:TROYER
Authorized Official - Suffix:
Authorized Official - Credentials:M,D
Authorized Official - Phone:928-453-4600
Mailing Address - Street 1:1000 N HUMPHREYS ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-3136
Mailing Address - Country:US
Mailing Address - Phone:928-779-3844
Mailing Address - Fax:928-779-3848
Practice Address - Street 1:1000 N HUMPHREYS ST
Practice Address - Street 2:SUITE 104
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-3136
Practice Address - Country:US
Practice Address - Phone:928-779-3844
Practice Address - Fax:928-779-3848
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TROYER URGENT CARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTC4263261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care