Provider Demographics
NPI:1598494403
Name:MY URGENT CARE, LLC
Entity Type:Organization
Organization Name:MY URGENT CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JAVAR
Authorized Official - Middle Name:
Authorized Official - Last Name:MYATT-JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-622-5501
Mailing Address - Street 1:202 E DR HICKS BLVD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-5768
Mailing Address - Country:US
Mailing Address - Phone:256-415-8326
Mailing Address - Fax:
Practice Address - Street 1:202 E DR HICKS BLVD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-5768
Practice Address - Country:US
Practice Address - Phone:256-415-8326
Practice Address - Fax:256-349-2723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-07
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care