Healthcare Provider Details

I. General information

NPI: 1780863985
Provider Name (Legal Business Name): NEVADA URGENT CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2007
Last Update Date: 10/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 N ELM ST
NEVADA MO
64772-2609
US

IV. Provider business mailing address

PO BOX 307
NEVADA MO
64772-0307
US

V. Phone/Fax

Practice location:
  • Phone: 417-667-9000
  • Fax: 417-667-9029
Mailing address:
  • Phone: 417-667-9000
  • Fax: 417-667-9029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number089091
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number089091
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number089091
License Number StateMO

VIII. Authorized Official

Name: DEBORAH S ASBERRY
Title or Position: OWNER
Credential: NP
Phone: 417-667-9000