Healthcare Provider Details

I. General information

NPI: 1659564797
Provider Name (Legal Business Name): MUSCATINE URGENT CARE, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2007
Last Update Date: 08/22/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1903 PARK AVE SUITE 1500
MUSCATINE IA
52761-5400
US

IV. Provider business mailing address

1903 PARK AVE SUITE 1500
MUSCATINE IA
52761-5400
US

V. Phone/Fax

Practice location:
  • Phone: 563-263-1903
  • Fax:
Mailing address:
  • Phone: 563-263-1903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number36998
License Number StateIA

VIII. Authorized Official

Name: DR. MAITREYI JANARTHANAN
Title or Position: PHYSICIAN
Credential: MD
Phone: 563-263-1903