Organization Name: | HUNT VALLEY URGENT CARE |
NPI Number: | 1194005512 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RONALD LEE BROADWATER (DOCTOR) |
Mailing Address: | 10 Warren Rd Suite 110 Cockeysville |
State: | MD US |
Postal Code: | 210302506 |
Phone Number: | 4106282140 |
Fax Number: | 4106674703 |
NPI Enumeration Date: | 08/17/2011 |
NPI Last Update Date: | 08/17/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QU0200X |
License Number: | D15200 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Urgent Care |
Taxonomy Definition: |