Provider Demographics
NPI:1932372307
Name:LEBONHEUR URGENT CARE, LLC
Entity Type:Organization
Organization Name:LEBONHEUR URGENT CARE, LLC
Other - Org Name:LEBONHEUR URGENT CARE DESOTO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JULOY
Authorized Official - Middle Name:
Authorized Official - Last Name:RAYMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-516-4176
Mailing Address - Street 1:6400 SHELBY VIEW DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38134-7659
Mailing Address - Country:US
Mailing Address - Phone:901-516-1489
Mailing Address - Fax:901-380-8081
Practice Address - Street 1:5480 GOODMAN RD
Practice Address - Street 2:SUITE 2
Practice Address - City:OLIVE BRANCH
Practice Address - State:MS
Practice Address - Zip Code:38654-7902
Practice Address - Country:US
Practice Address - Phone:662-893-9877
Practice Address - Fax:662-893-9828
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:METHODIST HEALTHCARE COMMUNITY CARE ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-08
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care