Provider Demographics
NPI:1932615077
Name:RAINCROSS URGENT CARE, INC.
Entity Type:Organization
Organization Name:RAINCROSS URGENT CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:W
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:951-774-2860
Mailing Address - Street 1:4646 BROCKTON AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-0104
Mailing Address - Country:US
Mailing Address - Phone:951-774-2881
Mailing Address - Fax:951-774-2846
Practice Address - Street 1:4646 BROCKTON AVE STE 101
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-0103
Practice Address - Country:US
Practice Address - Phone:951-774-2860
Practice Address - Fax:951-774-2861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-27
Last Update Date:2017-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care