Healthcare Provider Details

I. General information

NPI: 1376159053
Provider Name (Legal Business Name): QUICK MED CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2020
Last Update Date: 09/18/2020
Certification Date: 09/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10825 W MCDOWELL RD SUITE 100
AVONDALE AZ
85392
US

IV. Provider business mailing address

PO BOX 41638
PHOENIX AZ
85080-1638
US

V. Phone/Fax

Practice location:
  • Phone: 844-900-2567
  • Fax: 866-855-4243
Mailing address:
  • Phone: 844-900-2567
  • Fax: 866-855-4243

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: ROXANNA OCHOA
Title or Position: CREDENTIALIST
Credential:
Phone: 844-900-2567