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	:	1578118782
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HULIN URGENT CARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	1110 E SAINT PETER ST
Second Line	:
City	:	NEW IBERIA
State	:	LA
Zip	:	70560-3932
Country	:	US
Telephone Number	:	337-364-1166
Fax Number	:

Provider Business Practice Location Address
First Line	:	3333 PONTCHARTRAIN DR
Second Line	:
City	:	SLIDELL
State	:	LA
Zip	:	70458-4827
Country	:	US
Telephone Number	:	985-238-0320
Fax Number	:	985-238-0321

Authorized Official
Title or Position	:	OWNER
Name	:	CLAYT W. HULIN
Credential	:
Telephone Number	:	337-852-9530

Provider Enumeration Date	:	08/05/2019
Last Update Date	:	03/16/2020

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