Healthcare Provider Details

I. General information

NPI: 1558976522
Provider Name (Legal Business Name): HULIN URGENT CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2020
Last Update Date: 09/15/2020
Certification Date: 09/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5654 MAIN ST
ZACHARY LA
70791-4023
US

IV. Provider business mailing address

600 JEFFERSON ST STE 600
LAFAYETTE LA
70501-6987
US

V. Phone/Fax

Practice location:
  • Phone: 337-465-4600
  • Fax:
Mailing address:
  • Phone: 337-465-4600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KELLY PREJEAN
Title or Position: PROVIDER ENROLLMENT SPECIALIST
Credential:
Phone: 337-465-4600