Healthcare Provider Details

I. General information

NPI: 1144651852
Provider Name (Legal Business Name): URGENT CARE OF BATON ROUGE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2013
Last Update Date: 12/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8786 GOODWOOD BLVD SUITE 106
BATON ROUGE LA
70806-7917
US

IV. Provider business mailing address

202 VILLAGE CIR STE 1
SLIDELL LA
70458-5374
US

V. Phone/Fax

Practice location:
  • Phone: 225-927-6368
  • Fax: 225-927-6399
Mailing address:
  • Phone: 985-726-9605
  • Fax: 985-726-9633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: MICHELLE A GALLOWAY
Title or Position: PRESIDENT
Credential: RN, PCCN
Phone: 985-726-9605