Provider Demographics
NPI:1831435924
Name:PEREGRINE URGENT CARE INC.
Entity type:Organization
Organization Name:PEREGRINE URGENT CARE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER / PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:MARTINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-854-4351
Mailing Address - Street 1:7115 HERITAGE SQUARE DR
Mailing Address - Street 2:SUITE 1250
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530-5639
Mailing Address - Country:US
Mailing Address - Phone:574-272-2000
Mailing Address - Fax:574-272-3300
Practice Address - Street 1:7115 HERITAGE SQUARE DR
Practice Address - Street 2:SUITE 1250
Practice Address - City:GRANGER
Practice Address - State:IN
Practice Address - Zip Code:46530-5639
Practice Address - Country:US
Practice Address - Phone:574-272-2000
Practice Address - Fax:574-272-3300
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PEREGRINE URGENT CARE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-12-18
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care