Provider Demographics
NPI:1386952075
Name:HOPE URGENT CARE ROMULUS PLLC
Entity type:Organization
Organization Name:HOPE URGENT CARE ROMULUS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:PATTY
Authorized Official - Middle Name:
Authorized Official - Last Name:HORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-992-3499
Mailing Address - Street 1:9340 WAYNE RD
Mailing Address - Street 2:
Mailing Address - City:ROMULUS
Mailing Address - State:MI
Mailing Address - Zip Code:48174-1569
Mailing Address - Country:US
Mailing Address - Phone:734-992-3499
Mailing Address - Fax:734-992-3373
Practice Address - Street 1:9340 WAYNE RD
Practice Address - Street 2:
Practice Address - City:ROMULUS
Practice Address - State:MI
Practice Address - Zip Code:48174-1569
Practice Address - Country:US
Practice Address - Phone:734-992-3499
Practice Address - Fax:734-992-3373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-16
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301056997261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care