Healthcare Provider Details

I. General information

NPI: 1942696190
Provider Name (Legal Business Name): H GREGORY BACH PL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2015
Last Update Date: 01/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8200 OKEECHOBEE BLVD
WEST PALM BEACH FL
33411-2099
US

IV. Provider business mailing address

8200 OKEECHOBEE BLVD
WEST PALM BEACH FL
33411-2099
US

V. Phone/Fax

Practice location:
  • Phone: 561-964-1111
  • Fax: 561-967-3144
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberME98091
License Number StateFL

VIII. Authorized Official

Name: DR. HAROLD BACH
Title or Position: OWNER/PHYSICIAN
Credential: MD
Phone: 561-964-1111