Healthcare Provider Details
I. General information
NPI: 1114302965
Provider Name (Legal Business Name): INDIANA UNIVERSITY HEALTH URGENT CARE CENTERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/22/2015
Last Update Date: 07/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
90 E GARNER RD
BROWNSBURG IN
46112-9359
US
IV. Provider business mailing address
10319 JEFFERSON HWY
BATON ROUGE LA
70809-2730
US
V. Phone/Fax
- Phone: 225-214-9352
- Fax: 225-214-9349
- Phone: 225-214-9352
- Fax: 225-214-9349
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEVE
SELLARS
Title or Position: COO/PRESIDENT
Credential:
Phone: 225-214-9353