Healthcare Provider Details

I. General information

NPI: 1548103559
Provider Name (Legal Business Name): WALK-IN AND INTERMEDIATE CARE CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 S MCCLESKEY ST STE 857
BOAZ AL
35957-2187
US

IV. Provider business mailing address

214 S MCCLESKEY ST STE 857
BOAZ AL
35957-2187
US

V. Phone/Fax

Practice location:
  • Phone: 256-849-0500
  • Fax: 256-905-8483
Mailing address:
  • Phone: 205-451-6711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MESSALINA CHARISSE JORDAN
Title or Position: OWNER
Credential: DO
Phone: 205-451-6711