Provider Demographics
NPI:1518337997
Name:LEESVILLE URGENT CARE, LLC
Entity Type:Organization
Organization Name:LEESVILLE URGENT CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-239-2600
Mailing Address - Street 1:103 W UNIVERSITY PKWY
Mailing Address - Street 2:
Mailing Address - City:LEESVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71446-4734
Mailing Address - Country:US
Mailing Address - Phone:337-239-2600
Mailing Address - Fax:337-239-2601
Practice Address - Street 1:103 W UNIVERSITY PKWY
Practice Address - Street 2:
Practice Address - City:LEESVILLE
Practice Address - State:LA
Practice Address - Zip Code:71446-4734
Practice Address - Country:US
Practice Address - Phone:337-239-2600
Practice Address - Fax:337-239-2601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-29
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care