Provider Demographics
NPI:1811278716
Name:SOUTHFIELD CITY URGENT CARE PC
Entity type:Organization
Organization Name:SOUTHFIELD CITY URGENT CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LENA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMOUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-569-2600
Mailing Address - Street 1:23832 SOUTHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-8017
Mailing Address - Country:US
Mailing Address - Phone:248-569-2600
Mailing Address - Fax:
Practice Address - Street 1:23832 SOUTHFIELD RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-8017
Practice Address - Country:US
Practice Address - Phone:248-569-2600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-06
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301084551261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care