MEDICARE: HULIN URGENT CARE SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1083223150
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HULIN URGENT CARE SERVICES LLC

Provider Business Mailing Address
First Line	:	1012 PETROLEUM PKWY
Second Line	:
City	:	BROUSSARD
State	:	LA
Zip	:	70518-8020
Country	:	US
Telephone Number	:	337-465-4600
Fax Number	:

Provider Business Practice Location Address
First Line	:	4015 STERLINGTON RD
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71203-2535
Country	:	US
Telephone Number	:	318-543-0106
Fax Number	:	318-543-0107

Authorized Official
Title or Position	:	PROVIDER ENROLLMENT COORDINATOR
Name	:	KELLY PREJEAN
Credential	:
Telephone Number	:	337-465-4600

Provider Enumeration Date	:	07/24/2020
Last Update Date	:	07/24/2020

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