Organization Name: | CHILTON URGENT CARE, LLC |
NPI Number: | 1366857674 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL D BRUCE (CEO/OWNER) |
Mailing Address: | 1210 7th St S Clanton |
State: | AL US |
Postal Code: | 350453724 |
Phone Number: | 2052800620 |
Fax Number: | 2052800625 |
NPI Enumeration Date: | 06/25/2014 |
NPI Last Update Date: | 09/25/2014 |
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: |