Provider Demographics
NPI:1972971703
Name:FOLSOM URGENT CARE INC
Entity Type:Organization
Organization Name:FOLSOM URGENT CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:CAPEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-479-9110
Mailing Address - Street 1:1520 E COVELL BLVD
Mailing Address - Street 2:SUITE 351
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-1366
Mailing Address - Country:US
Mailing Address - Phone:916-479-9110
Mailing Address - Fax:916-226-2656
Practice Address - Street 1:1600 CREEKSIDE DR
Practice Address - Street 2:SUITE 1400
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3444
Practice Address - Country:US
Practice Address - Phone:916-984-8244
Practice Address - Fax:916-984-8206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-10
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty