Provider Demographics
NPI:1548414501
Name:URGENT CARE OF THE UPSTATE, INC.
Entity Type:Organization
Organization Name:URGENT CARE OF THE UPSTATE, INC.
Other - Org Name:INTEGRATIVE PAIN MANAGEMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:A
Authorized Official - Last Name:GALLOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-726-9605
Mailing Address - Street 1:202 VILLAGE CIR STE 1
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458
Mailing Address - Country:US
Mailing Address - Phone:985-726-9605
Mailing Address - Fax:985-726-9633
Practice Address - Street 1:556 MEMORIAL DRIVE EXT STE A
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29651-1154
Practice Address - Country:US
Practice Address - Phone:864-848-2300
Practice Address - Fax:864-848-2323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-04
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care