Provider Demographics
NPI:1720505134
Name:URGENT CARE OF LAFAYETTE
Entity Type:Organization
Organization Name:URGENT CARE OF LAFAYETTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:A
Authorized Official - Last Name:GALLOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-726-9605
Mailing Address - Street 1:202 VILLAGE CIR STE 1
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-5418
Mailing Address - Country:US
Mailing Address - Phone:985-726-9605
Mailing Address - Fax:
Practice Address - Street 1:913 S COLLEGE RD STE 203
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-3062
Practice Address - Country:US
Practice Address - Phone:337-237-5781
Practice Address - Fax:337-234-5341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-25
Last Update Date:2017-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care