Healthcare Provider Details
I. General information
NPI: 1629665435
Provider Name (Legal Business Name): HULIN URGENT CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/28/2020
Last Update Date: 01/06/2021
Certification Date: 01/06/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
300 HOSPITAL RD
NEW ROADS LA
70760-2621
US
IV. Provider business mailing address
600 JEFFERSON ST STE 600
LAFAYETTE LA
70501-6987
US
V. Phone/Fax
- Phone: 225-310-6501
- Fax: 225-310-6502
- Phone: 337-202-0720
- 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: 337-465-4600