1447610373 NPI number — THE URGENT CARE CENTER OF RICHMOND HILL, LLC

Table of content: (NPI 1447610373)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447610373 NPI number — THE URGENT CARE CENTER OF RICHMOND HILL, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE URGENT CARE CENTER OF RICHMOND HILL, LLC
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:
EXPERCARE
Provider Other Organization Name Type Code:
3
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:
1447610373
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/30/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
60 EXCHANGE ST STE B7
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RICHMOND HILL
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31324-7646
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
912-756-2273
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
318 MALL BLVD STE 300B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAVANNAH
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31406-4758
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
912-358-1515
Provider Business Practice Location Address Fax Number:
912-480-0505
Provider Enumeration Date:
03/04/2016

Additional Information

Authorized Official

Authorized Official Last Name:
GRANT
Authorized Official First Name:
CATHERINE
Authorized Official Middle Name:
CORISH
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
912-756-2273

Provider Taxonomy Codes

  • Taxonomy code: 261QU0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QX0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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