Provider Demographics
NPI:1639374317
Name:TROYER URGENT CARE, INC.
Entity Type:Organization
Organization Name:TROYER URGENT CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDAL
Authorized Official - Middle Name:L
Authorized Official - Last Name:TROYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-453-4600
Mailing Address - Street 1:1810 MESQUITE AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86403-5886
Mailing Address - Country:US
Mailing Address - Phone:928-453-4600
Mailing Address - Fax:928-453-4606
Practice Address - Street 1:1810 MESQUITE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403-5886
Practice Address - Country:US
Practice Address - Phone:928-453-4600
Practice Address - Fax:928-453-4606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ260741Medicaid
AZZ116757Medicare PIN
AZ6030680001Medicare NSC