Healthcare Provider Details
I. General information
NPI: 1235890773
Provider Name (Legal Business Name): RURAL URGENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/06/2022
Last Update Date: 01/06/2022
Certification Date: 01/06/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3910 WASHINGTON RD
AUGUSTA GA
30907-2349
US
IV. Provider business mailing address
1500 1ST AVE N UNIT 3
BIRMINGHAM AL
35203-1866
US
V. Phone/Fax
- Phone: 205-545-5085
- Fax:
- Phone: 205-545-5085
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANDREW
SMITH
Title or Position: DIRECTOR
Credential:
Phone: 205-545-5085