Healthcare Provider Details

I. General information

NPI: 1275919185
Provider Name (Legal Business Name): CENTRAL ALABAMA URGENT CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2015
Last Update Date: 08/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 MIDWAY PLZ SUITE B
DORA AL
35062-9340
US

IV. Provider business mailing address

27 MIDWAY PLZ SUITE B
DORA AL
35062-9340
US

V. Phone/Fax

Practice location:
  • Phone: 417-861-9739
  • Fax: 417-429-2893
Mailing address:
  • Phone: 417-861-9739
  • Fax: 417-429-2893

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: STEVEN ADERHOLT
Title or Position: OWNER
Credential:
Phone: 215-388-1328