Healthcare Provider Details
I. General information
NPI: 1922316967
Provider Name (Legal Business Name): URGENT CARE SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/23/2010
Last Update Date: 09/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1640 45TH AVE
MUNSTER IN
46321-3914
US
IV. Provider business mailing address
55 E 86TH AVE
MERRILLVILLE IN
46410-6382
US
V. Phone/Fax
- Phone: 219-513-0999
- Fax: 219-513-9032
- Phone: 219-769-1670
- Fax: 219-738-6714
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | 01039726 |
| License Number State | IN |
VIII. Authorized Official
Name:
SHAHEEN
PARVEZ
Title or Position: PRESIDENT
Credential: MD
Phone: 219-513-0999