| Organization Name: | FULTONDALE URGENT CARE CENTERS, LLC |
| NPI Number: | 1659697696 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KENNETH C. RANDALL (CHIEF ADMINISTRATIVE OFFICER) |
| Mailing Address: | 339 Walker Chapel Plaza Suite 115 Fultondale |
| State: | AL US |
| Postal Code: | 35068 |
| Phone Number: | 2058412844 |
| Fax Number: | 2053807579 |
| NPI Enumeration Date: | 04/15/2010 |
| NPI Last Update Date: | 11/09/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |