Provider Demographics
NPI:1558454132
Name:BAPTIST URGENT CARE, LLC
Entity Type:Organization
Organization Name:BAPTIST URGENT CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:T
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-469-2338
Mailing Address - Street 1:9400 UNIVERSITY PARKWAY SUITE 101B
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514
Mailing Address - Country:US
Mailing Address - Phone:850-208-6130
Mailing Address - Fax:850-208-6135
Practice Address - Street 1:9400 UNIVERSITY PARKWAY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514
Practice Address - Country:US
Practice Address - Phone:850-208-6130
Practice Address - Fax:850-208-6135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CK2987OtherMEDICARE RAILROAD
FLB906ZOtherBCBSFL
FL259794200Medicaid
FL259794200Medicaid
FLA832OtherHEALTHEASE
K2979Medicare ID - Type Unspecified