Provider Demographics
NPI:1508471418
Name:WATERLOO URGENT CARE WALK IN CLINIC COMPANY
Entity Type:Organization
Organization Name:WATERLOO URGENT CARE WALK IN CLINIC COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:MOLNAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-948-3055
Mailing Address - Street 1:14671 TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48239-3300
Mailing Address - Country:US
Mailing Address - Phone:131-394-8305
Mailing Address - Fax:313-948-3041
Practice Address - Street 1:901 ILLINOIS ROUTE 3
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IL
Practice Address - Zip Code:62298
Practice Address - Country:US
Practice Address - Phone:313-948-3055
Practice Address - Fax:248-250-6430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-09
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care