Healthcare Provider Details

I. General information

NPI: 1386952075
Provider Name (Legal Business Name): HOPE URGENT CARE ROMULUS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2010
Last Update Date: 01/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9340 WAYNE RD
ROMULUS MI
48174-1569
US

IV. Provider business mailing address

9340 WAYNE RD
ROMULUS MI
48174-1569
US

V. Phone/Fax

Practice location:
  • Phone: 734-992-3499
  • Fax: 734-992-3373
Mailing address:
  • Phone: 734-992-3499
  • Fax: 734-992-3373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number4301056997
License Number StateMI

VIII. Authorized Official

Name: MISS PATTY HORN
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 734-992-3499