| Organization Name: | BETHEL URGENT CARE CENTER LLC |
| NPI Number: | 1053768994 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MATTHEW DAVID AMARA (OWNER) |
| Mailing Address: | 6 Stony Hill Rd Bethel |
| State: | CT US |
| Postal Code: | 068011053 |
| Phone Number: | 2032997191 |
| Fax Number: | 2034033647 |
| NPI Enumeration Date: | 05/20/2016 |
| NPI Last Update Date: | 05/26/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QU0200X |
| License Number: | 000438 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CT |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Urgent Care |
| Taxonomy Definition: | |