Provider Demographics
NPI:1013332378
Name:PATIENT PAL URGENT CARE LLC
Entity type:Organization
Organization Name:PATIENT PAL URGENT CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:RN, CPCS
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:
Authorized Official - Last Name:PADILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-737-2273
Mailing Address - Street 1:11860 SOUTHERN HIGHLANDS PKWY
Mailing Address - Street 2:#102
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89141-3303
Mailing Address - Country:US
Mailing Address - Phone:702-737-2273
Mailing Address - Fax:702-823-2556
Practice Address - Street 1:11860 SOUTHERN HIGHLANDS PKWY
Practice Address - Street 2:#102
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89141-3303
Practice Address - Country:US
Practice Address - Phone:702-737-2273
Practice Address - Fax:702-823-2556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-24
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2000179062190261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV=========OtherTAX ID