Provider Demographics
NPI:1679991459
Name:EMED URGENT CARE CENTER PA
Entity Type:Organization
Organization Name:EMED URGENT CARE CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RENE
Authorized Official - Middle Name:U
Authorized Official - Last Name:PULIDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-647-8576
Mailing Address - Street 1:2624 ATLANTIC BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-3668
Mailing Address - Country:US
Mailing Address - Phone:904-647-8576
Mailing Address - Fax:904-306-9174
Practice Address - Street 1:2624 ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-3668
Practice Address - Country:US
Practice Address - Phone:904-647-8576
Practice Address - Fax:904-306-9174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-31
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care