Healthcare Provider Details

I. General information

NPI: 1285180729
Provider Name (Legal Business Name): ENTERPRISE URGENT CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2016
Last Update Date: 02/21/2020
Certification Date: 02/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6582 BOLL WEEVIL CIRCLE
ENTERPRISE AL
36330
US

IV. Provider business mailing address

6582 BOLL WEEVIL CIRCLE
ENTERPRISE AL
36330
US

V. Phone/Fax

Practice location:
  • Phone: 334-347-2027
  • Fax:
Mailing address:
  • Phone: 334-347-2027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MICHAEL D BRUCE
Title or Position: CEO
Credential:
Phone: 334-567-4311