Provider Demographics
NPI:1184810822
Name:MARTINEZ URGENT CARE
Entity type:Organization
Organization Name:MARTINEZ URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATE
Authorized Official - Middle Name:
Authorized Official - Last Name:DANILOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-855-1755
Mailing Address - Street 1:210 OAK ST
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-5139
Mailing Address - Country:US
Mailing Address - Phone:706-651-9208
Mailing Address - Fax:706-863-2587
Practice Address - Street 1:210 OAK ST
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-5139
Practice Address - Country:US
Practice Address - Phone:706-651-9208
Practice Address - Fax:706-863-2587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-17
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA027003261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP220Medicare PIN
GAD39497Medicare UPIN