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NPI Code Detail

MEDICARE: ST JOHN HARRISON TOWNSHIP URGENT CARE

MEDICARE: ST JOHN HARRISON TOWNSHIP URGENT CARE
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
1261QU0200XUrgent Care Clinic/Center

General Provider Information

NPI Number : 1750680757
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST JOHN HARRISON TOWNSHIP URGENT CARE
Provider Business Mailing Address
First Line : 28000 DEQUINDRE RD
Second Line :
City : WARREN
State : MI
Zip : 48092-2468
Country : US
Telephone Number : 248-680-8000
Fax Number :
Provider Business Practice Location Address
First Line : 25990 CROCKER BLVD
Second Line :
City : HARRISON TWP
State : MI
Zip : 48045-3450
Country : US
Telephone Number : 586-466-5466
Fax Number :
Authorized Official
Title or Position : CFO
Name : TOMASINE MARX
Credential :
Telephone Number : 313-343-7676
Provider Enumeration Date : 03/17/2011
Last Update Date : 09/21/2022

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Directions to “ST JOHN HARRISON TOWNSHIP URGENT CARE ” Practice Location

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