Healthcare Provider Details

I. General information

NPI: 1386708097
Provider Name (Legal Business Name): TMC IMMEDIATE CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 02/29/2024
Certification Date: 02/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 QUARTZ DR SUITE 101
VILLA RICA GA
30180-3255
US

IV. Provider business mailing address

100 GREENWAY BLVD FL 2
CARROLLTON GA
30117-4338
US

V. Phone/Fax

Practice location:
  • Phone: 770-949-7500
  • Fax: 770-942-8800
Mailing address:
  • Phone: 770-838-8710
  • Fax: 770-812-5735

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CLINT HOFFMAN
Title or Position: SR VP
Credential:
Phone: 770-812-8845