Organization Name: | TOWN CENTER URGENT CARE LLC |
NPI Number: | 1033471271 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHAD BLACK (OWNER/PARTNER) |
Mailing Address: | 610 Sycamore St Celebration |
State: | FL US |
Postal Code: | 347474995 |
Phone Number: | 3867886616 |
Fax Number: | |
NPI Enumeration Date: | 06/13/2012 |
NPI Last Update Date: | 06/13/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QU0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Urgent Care |
Taxonomy Definition: |