Provider Demographics
NPI:1790716363
Name:GREENWOOD URGENT CARE CENTER INC
Entity Type:Organization
Organization Name:GREENWOOD URGENT CARE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:TUTSE
Authorized Official - Middle Name:
Authorized Official - Last Name:TONWE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-423-1118
Mailing Address - Street 1:640 S QUEEN ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-3565
Mailing Address - Country:US
Mailing Address - Phone:302-734-1759
Mailing Address - Fax:302-734-4401
Practice Address - Street 1:640 S QUEEN ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3565
Practice Address - Country:US
Practice Address - Phone:302-734-1759
Practice Address - Fax:302-734-4401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2014-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health