Healthcare Provider Details

I. General information

NPI: 1356309249
Provider Name (Legal Business Name): REGIONAL URGENT CARE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 11/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 13TH ST SUITE 200
COLUMBUS GA
31901-2101
US

IV. Provider business mailing address

PO BOX 1038
COLUMBUS GA
31902-1038
US

V. Phone/Fax

Practice location:
  • Phone: 706-494-4949
  • Fax: 706-494-4940
Mailing address:
  • Phone: 706-660-6410
  • Fax: 706-660-2847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: LIBBY RENFROE
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 706-660-6410