Healthcare Provider Details
I. General information
NPI: 1134774144
Provider Name (Legal Business Name): HULIN URGENT CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/06/2019
Last Update Date: 03/16/2020
Certification Date: 03/16/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
160 SAN ANTONIO AVE
MANY LA
71449
US
IV. Provider business mailing address
1110 E SAINT PETER ST
NEW IBERIA LA
70560-3932
US
V. Phone/Fax
- Phone: 318-353-3412
- Fax: 318-353-3413
- Phone: 337-364-1166
- Fax:
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:
CLAYT
W.
HULIN
Title or Position: OWNER
Credential:
Phone: 337-852-9530