Healthcare Provider Details

I. General information

NPI: 1942318308
Provider Name (Legal Business Name): AURORA URGENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2006
Last Update Date: 02/21/2020
Certification Date: 02/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 32ND AVE S STE D
GRAND FORKS ND
58201
US

IV. Provider business mailing address

PO BOX 5210
GRAND FORKS ND
58206-5210
US

V. Phone/Fax

Practice location:
  • Phone: 701-732-2710
  • Fax: 701-732-2711
Mailing address:
  • Phone: 701-732-2710
  • Fax: 701-732-2711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CEDRIC B MASA
Title or Position: MD
Credential:
Phone: 701-732-2710