Provider Demographics
NPI:1346687241
Name:EDMOND URGENT CARE INC.
Entity Type:Organization
Organization Name:EDMOND URGENT CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTH OFFICAL
Authorized Official - Prefix:
Authorized Official - First Name:TOMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-285-2161
Mailing Address - Street 1:1101 NW 178TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-4281
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1101 NW 178TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73012-4281
Practice Address - Country:US
Practice Address - Phone:405-799-7400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-31
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care