Healthcare Provider Details

I. General information

NPI: 1225706773
Provider Name (Legal Business Name): MAXEM HEALTH URGENT CARE MOBILE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2021
Last Update Date: 08/31/2021
Certification Date: 08/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 SCHILLINGER RD S STE A
MOBILE AL
36695-8915
US

IV. Provider business mailing address

PO BOX 1248
OCEAN SPRINGS MS
39566-1248
US

V. Phone/Fax

Practice location:
  • Phone: 228-223-1927
  • Fax:
Mailing address:
  • Phone: 707-319-5068
  • 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. RONNIE ALI
Title or Position: OWNER
Credential: DO
Phone: 228-223-1927