Provider Demographics
NPI:1821233354
Name:THE URGENT CARE CENTER OF RICHMOND HILL, LLC
Entity type:Organization
Organization Name:THE URGENT CARE CENTER OF RICHMOND HILL, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:CORISH
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:912-756-2273
Mailing Address - Street 1:60 EXCHANGE ST STE B7
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-7646
Mailing Address - Country:US
Mailing Address - Phone:912-756-2273
Mailing Address - Fax:912-756-3773
Practice Address - Street 1:60 EXCHANGE ST STE B7
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324-7646
Practice Address - Country:US
Practice Address - Phone:912-756-2273
Practice Address - Fax:912-756-3773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-12
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA6465520001Medicare NSC