Provider Demographics
NPI:1750665261
Name:GRANBY URGENT CARE LLC
Entity Type:Organization
Organization Name:GRANBY URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:KEI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-653-2382
Mailing Address - Street 1:7 MILL POND RD
Mailing Address - Street 2:
Mailing Address - City:GRANBY
Mailing Address - State:CT
Mailing Address - Zip Code:06035-2637
Mailing Address - Country:US
Mailing Address - Phone:860-653-2382
Mailing Address - Fax:860-653-6235
Practice Address - Street 1:7 MILL POND RD
Practice Address - Street 2:
Practice Address - City:GRANBY
Practice Address - State:CT
Practice Address - Zip Code:06035-2637
Practice Address - Country:US
Practice Address - Phone:860-653-2382
Practice Address - Fax:860-653-6235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-03
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty