Healthcare Provider Details

I. General information

NPI: 1154092815
Provider Name (Legal Business Name): RURAL URGENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2021
Last Update Date: 09/22/2021
Certification Date: 09/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 MACON RD STE 109
COLUMBUS GA
31906-1741
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 706-225-8773
  • Fax:
Mailing address:
  • Phone: 256-854-9989
  • 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
Credential:
Phone: 205-545-5085