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General NPI Number Information
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NPI Number | 1407364797
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Entity Type | Organization
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Legal Business Name | ALPHA URGENT CARE PLLC
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Dates
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Enumeration Date | 01/20/2018
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Last Update Date | 01/20/2018
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Provider Practice Location Address
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Address Line | 6500 SIX MILE LN
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City | LOUISVILLE
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State | KY
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Zip | 40218-2355
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Country | US
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Telephone | 502-619-1109
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Fax |
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Provider Business Mailing Address
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Address Line | 6301 GLEN HILL RD
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City | LOUISVILLE
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State | KY
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Zip | 40222-6026
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Country | US
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Telephone | 502-619-1109
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | KHALED JOUJ
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Credential | M.D.
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Telephone | 502-619-1109
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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 |
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License Number State |
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