Provider Demographics
NPI:1760919625
Name:EAST BEACH URGENT CARE LLC
Entity Type:Organization
Organization Name:EAST BEACH URGENT CARE LLC
Other - Org Name:EAST BEACH URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-491-8795
Mailing Address - Street 1:9545 SHORE DR
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23518-1711
Mailing Address - Country:US
Mailing Address - Phone:757-785-4861
Mailing Address - Fax:
Practice Address - Street 1:9545 SHORE DR
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23518-1711
Practice Address - Country:US
Practice Address - Phone:757-785-4861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty