Provider Demographics
NPI:1518581685
Name:HULIN URGENT CARE SERVICES, LLC
Entity Type:Organization
Organization Name:HULIN URGENT CARE SERVICES, LLC
Other - Org Name:SOUTHSTAR URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER ENROLLMENT COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:PREJEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-296-2527
Mailing Address - Street 1:1012 PETROLEUM PKWY
Mailing Address - Street 2:
Mailing Address - City:BROUSSARD
Mailing Address - State:LA
Mailing Address - Zip Code:70518-8020
Mailing Address - Country:US
Mailing Address - Phone:337-465-4600
Mailing Address - Fax:
Practice Address - Street 1:6420 GROOM RD
Practice Address - Street 2:
Practice Address - City:BAKER
Practice Address - State:LA
Practice Address - Zip Code:70714-4336
Practice Address - Country:US
Practice Address - Phone:225-412-2781
Practice Address - Fax:225-412-2782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-03
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care