Provider Demographics
NPI:1184385791
Name:ROMEO PLANK URGENT CARE PLLC
Entity type:Organization
Organization Name:ROMEO PLANK URGENT CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-992-5500
Mailing Address - Street 1:45194 ROMEO PLANK RD
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-4207
Mailing Address - Country:US
Mailing Address - Phone:248-289-1590
Mailing Address - Fax:248-716-7320
Practice Address - Street 1:45194 ROMEO PLANK RD
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48044-4207
Practice Address - Country:US
Practice Address - Phone:586-992-5500
Practice Address - Fax:248-716-7320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-05
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care