| Organization Name: | ALTUS URGENT CARE, LLC |
| NPI Number: | 1194193433 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TOM STEPHEN CARTER (OWNER) |
| Mailing Address: | 1015 E Broadway St Suite 101 Altus |
| State: | OK US |
| Postal Code: | 735215505 |
| Phone Number: | 5803790855 |
| Fax Number: | 5803790867 |
| NPI Enumeration Date: | 09/03/2015 |
| NPI Last Update Date: | 02/19/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QU0200X |
| License Number: | 18517 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Urgent Care |
| Taxonomy Definition: | |