Provider Demographics
NPI:1013154533
Name:ALLIANCE URGENT CARE, LLC
Entity Type:Organization
Organization Name:ALLIANCE URGENT CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ARNEL
Authorized Official - Last Name:RAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO, MPH
Authorized Official - Phone:770-888-2733
Mailing Address - Street 1:610 PEACHTREE PARKWAY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041
Mailing Address - Country:US
Mailing Address - Phone:770-888-2733
Mailing Address - Fax:770-888-2741
Practice Address - Street 1:610 PEACHTREE PARKWAY
Practice Address - Street 2:SUITE 201
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041
Practice Address - Country:US
Practice Address - Phone:770-888-2733
Practice Address - Fax:770-888-2741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-21
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA033682261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD38576Medicare UPIN