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General NPI Number Information
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NPI Number | 1467601765
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Entity Type | Organization
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Legal Business Name | COLLEGE DRIVE URGENT CARE LLC
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Dates
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Enumeration Date | 09/11/2008
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 2030 BLUEGRASS CIR
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City | CHEYENNE
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State | WY
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Zip | 82009-7328
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Country | US
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Telephone | 307-635-3500
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Fax | 307-635-2199
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Provider Business Mailing Address
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Address Line | 2145 E BASELINE RD STE 303
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City | TEMPE
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State | AZ
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Zip | 85283-1515
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Country | US
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Telephone | 888-705-8558
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Fax | 480-776-0025
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | MR. CHRIS M KANE
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Credential |
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Telephone | 888-705-8558
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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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