Provider Demographics
NPI:1508010828
Name:URGENT CARE INC
Entity Type:Organization
Organization Name:URGENT CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:PATCHES
Authorized Official - Middle Name:
Authorized Official - Last Name:RHODE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:228-466-5656
Mailing Address - Street 1:PO BOX 869
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:MS
Mailing Address - Zip Code:39560-0869
Mailing Address - Country:US
Mailing Address - Phone:228-365-6460
Mailing Address - Fax:
Practice Address - Street 1:852 HIGHWAY 90
Practice Address - Street 2:
Practice Address - City:BAY ST LOUIS
Practice Address - State:MS
Practice Address - Zip Code:39520-2701
Practice Address - Country:US
Practice Address - Phone:228-463-1900
Practice Address - Fax:228-463-2322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-13
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty