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General NPI Number Information
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NPI Number | 1437048550
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Entity Type | Organization
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Legal Business Name | MAIN STREET URGENT CARE & WELLNESS CLINIC LLC
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Dates
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Enumeration Date | 07/02/2025
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 144 US HIGHWAY 278
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City | GUIN
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State | AL
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Zip | 35563
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Country | US
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Telephone | 205-269-2448
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Fax |
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Provider Business Mailing Address
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Address Line | 144 US HIGHWAY 278
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City | GUIN
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State | AL
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Zip | 35563
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | HOLLY COOPER
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Credential | NP
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Telephone | 205-269-2448
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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