Provider Demographics
NPI:1659635449
Name:REIDS COMMUNITY URGENT CARE PLLC
Entity Type:Organization
Organization Name:REIDS COMMUNITY URGENT CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MOE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILCOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-376-5856
Mailing Address - Street 1:9938 HARPER AVE STE C
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48213-3110
Mailing Address - Country:US
Mailing Address - Phone:313-921-2100
Mailing Address - Fax:313-921-2101
Practice Address - Street 1:9938 HARPER AVE STE C
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48213-3110
Practice Address - Country:US
Practice Address - Phone:313-921-2100
Practice Address - Fax:313-921-2101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-27
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty