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General NPI Number Information
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NPI Number | 1235366345
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Entity Type | Organization
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Legal Business Name | URGENT CARE XPRESS, LLC
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Dates
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Enumeration Date | 06/16/2009
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Last Update Date | 08/08/2011
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Provider Practice Location Address
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Address Line | 3330 SOUTH COBB DRIVE STE: B
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City | SMYRNA
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State | GA
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Zip | 30080
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Country | US
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Telephone | 770-434-7830
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Fax | 770-434-7834
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Provider Business Mailing Address
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Address Line | 3316A SOUTH COBB DRIVE STE: 187
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City | SMYRNA
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State | GA
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Zip | 30080
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Country | US
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Telephone | 770-434-7830
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Fax | 770-434-7834
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Authorized Official
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Title or Position | CFO/COO
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Name | MR. MARC JAY TAWIL
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Credential |
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Telephone | 770-434-7830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 2009275
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 2009275
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License Number State | GA
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