Healthcare Provider Details

I. General information

NPI: 1922672245
Provider Name (Legal Business Name): ELITE URGENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2021
Last Update Date: 05/20/2021
Certification Date: 05/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4682 AIRPORT BLVD
MOBILE AL
36608-3124
US

IV. Provider business mailing address

12035 70TH AVE
BLUE GRASS IA
52726-9694
US

V. Phone/Fax

Practice location:
  • Phone: 563-528-1013
  • Fax:
Mailing address:
  • Phone: 563-528-1013
  • 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: PHILIP JONES
Title or Position: CEO
Credential:
Phone: 563-528-1013