Provider Demographics
NPI:1477873263
Name:MD URGENT CARE, LLC
Entity Type:Organization
Organization Name:MD URGENT CARE, LLC
Other - Org Name:MEDHELP URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-713-2600
Mailing Address - Street 1:2076 ASGARD CT NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-3889
Mailing Address - Country:US
Mailing Address - Phone:404-579-4124
Mailing Address - Fax:404-325-7955
Practice Address - Street 1:3515 CAMP CREEK PARKWAY
Practice Address - Street 2:STE 110
Practice Address - City:EAST POINT
Practice Address - State:GA
Practice Address - Zip Code:30344-8140
Practice Address - Country:US
Practice Address - Phone:404-579-4124
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-03
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care