MEDICARE: QUICK VISIT URGENT CARE CNTR

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	:	1942337837
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUICK VISIT URGENT CARE CNTR

Provider Business Mailing Address
First Line	:	1930 W THUNDERBIRD RD
Second Line	:	SUITE 102
City	:	PHOENIX
State	:	AZ
Zip	:	85023-6369
Country	:	US
Telephone Number	:	602-850-0000
Fax Number	:	602-346-9999

Provider Business Practice Location Address
First Line	:	1930 W THUNDERBIRD RD
Second Line	:	SUITE 102
City	:	PHOENIX
State	:	AZ
Zip	:	85023-6369
Country	:	US
Telephone Number	:	602-850-0000
Fax Number	:	602-346-9999

Authorized Official
Title or Position	:	OWNER
Name	:	SHASHI JAIN GOEL
Credential	:	MD
Telephone Number	:	602-850-0000

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	04/20/2008

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