Healthcare Provider Details

I. General information

NPI: 1376173906
Provider Name (Legal Business Name): RURAL URGENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2020
Last Update Date: 01/23/2020
Certification Date: 01/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1408 TALLAHASSEE HWY STE Z
BAINBRIDGE GA
39819-7791
US

IV. Provider business mailing address

1500 1ST AVE N UNIT 3
BIRMINGHAM AL
35203-1866
US

V. Phone/Fax

Practice location:
  • Phone: 229-400-9033
  • Fax: 229-337-2406
Mailing address:
  • Phone:
  • 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: ANDREW SMITH
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 205-545-5085