Provider Demographics
NPI:1467562058
Name:URGENT CARE PC
Entity Type:Organization
Organization Name:URGENT CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:205-981-9533
Mailing Address - Street 1:2016 STONEGATE TRAIL
Mailing Address - Street 2:SUITE 112
Mailing Address - City:VESTAVIA HILLS
Mailing Address - State:AL
Mailing Address - Zip Code:35242-2260
Mailing Address - Country:US
Mailing Address - Phone:205-545-9530
Mailing Address - Fax:205-545-9529
Practice Address - Street 1:3143 PELHAM PKWY STE 100
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-2028
Practice Address - Country:US
Practice Address - Phone:205-620-2273
Practice Address - Fax:205-620-2279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC144OtherBLUE CROSS BLUE SHIELD
ALC144OtherBLUE CROSS BLUE SHIELD