Provider Demographics
NPI:1538502307
Name:COMMUNITY URGENT CARE PLLC
Entity Type:Organization
Organization Name:COMMUNITY URGENT CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FAIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:RAHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-792-1200
Mailing Address - Street 1:1816 GRINDLEY PARK ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2504
Mailing Address - Country:US
Mailing Address - Phone:313-792-1200
Mailing Address - Fax:313-792-1201
Practice Address - Street 1:1816 GRINDLEY PARK ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2504
Practice Address - Country:US
Practice Address - Phone:313-792-1200
Practice Address - Fax:313-792-1201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-11
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301080612261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care