Provider Demographics
NPI:1467897678
Name:HIMES WALK IN CLINIC, LLC
Entity Type:Organization
Organization Name:HIMES WALK IN CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:W
Authorized Official - Last Name:HEARIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:813-933-1096
Mailing Address - Street 1:8011 N HIMES AVE
Mailing Address - Street 2:STE 4
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-2700
Mailing Address - Country:US
Mailing Address - Phone:813-933-1096
Mailing Address - Fax:813-932-0439
Practice Address - Street 1:8011 N HIMES AVE
Practice Address - Street 2:STE 4
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2700
Practice Address - Country:US
Practice Address - Phone:813-933-1096
Practice Address - Fax:813-932-0439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-01
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center