Provider Demographics
NPI:1780076026
Name:CERIUM URGENT CARE
Entity type:Organization
Organization Name:CERIUM URGENT CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SONDI
Authorized Official - Middle Name:SAADIA
Authorized Official - Last Name:MOORE-WATERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-297-3440
Mailing Address - Street 1:2260 NORTHLAKE PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-4006
Mailing Address - Country:US
Mailing Address - Phone:404-297-3440
Mailing Address - Fax:404-855-4303
Practice Address - Street 1:2260 NORTHLAKE PKWY STE 300
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-4006
Practice Address - Country:US
Practice Address - Phone:404-376-8325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-24
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care