1083761712 NPI number — THE HEIGHTS URGENT CARE PLLC

Table of content: DR. RAVEENDRA BABU ORUGUNTA M.D (NPI 1639177207)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083761712 NPI number — THE HEIGHTS URGENT CARE PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE HEIGHTS URGENT CARE PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1083761712
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
337 INKSTER RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
INKSTER
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48141-1208
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
313-562-9000
Provider Business Mailing Address Fax Number:
313-562-9407

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
337 INKSTER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INKSTER
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48141-1208
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-562-9000
Provider Business Practice Location Address Fax Number:
313-562-9407
Provider Enumeration Date:
01/04/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KAWAR
Authorized Official First Name:
SAMEEH
Authorized Official Middle Name:
MOHAMAD
Authorized Official Title or Position:
OWNER PRESIDENT
Authorized Official Telephone Number:
313-562-9000

Provider Taxonomy Codes

  • Taxonomy code: 261QU0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)