Provider Demographics
NPI:1821671041
Name:PREMIER URGENT CARE INC.
Entity Type:Organization
Organization Name:PREMIER URGENT CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS AND BILLING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:TESSE
Authorized Official - Middle Name:T
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-849-9197
Mailing Address - Street 1:5856 HIGHWAY 53 STE 200A
Mailing Address - Street 2:
Mailing Address - City:HARVEST
Mailing Address - State:AL
Mailing Address - Zip Code:35749-4305
Mailing Address - Country:US
Mailing Address - Phone:256-858-1398
Mailing Address - Fax:
Practice Address - Street 1:2246 WINCHESTER RD NE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35811-6800
Practice Address - Country:US
Practice Address - Phone:256-929-4224
Practice Address - Fax:888-498-4821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-05
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1356859391OtherNPI
AL1427549823OtherNPI
AL1437700606OtherNPI
AL1659890945OtherNPI