Healthcare Provider Details
I. General information
NPI: 1760959720
Provider Name (Legal Business Name): OUR URGENT CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/29/2018
Last Update Date: 12/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2893 VETERANS MEMORIAL PKWY
SAINT CHARLES MO
63303-3526
US
IV. Provider business mailing address
2893 VETERANS MEMORIAL PKWY
SAINT CHARLES MO
63303-3526
US
V. Phone/Fax
- Phone: 636-255-8174
- Fax: 636-639-2368
- Phone: 636-887-3020
- 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:
JOSEPH
SEIBEL
Title or Position: PRESIDENT
Credential:
Phone: 636-887-3020