Healthcare Provider Details

I. General information

NPI: 1740458033
Provider Name (Legal Business Name): URGENT CARE EXPRESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2008
Last Update Date: 03/29/2023
Certification Date: 03/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4950 E BLUE GRASS RD
MT PLEASANT MI
48858-6020
US

IV. Provider business mailing address

4950 E BLUE GRASS RD
MT PLEASANT MI
48858-6020
US

V. Phone/Fax

Practice location:
  • Phone: 989-317-0565
  • Fax: 989-317-0567
Mailing address:
  • Phone: 989-317-0565
  • Fax: 989-317-0567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number4301061761
License Number StateMI

VIII. Authorized Official

Name: KENYON HALL
Title or Position: OFFICE MANAGER
Credential:
Phone: 989-317-0565