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General NPI Number Information
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NPI Number | 1528046323
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Entity Type | Organization
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Legal Business Name | PHYSICIANS IMMEDIATE CARE LTD
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Dates
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Enumeration Date | 01/03/2006
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 3475 S ALPINE RD
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City | ROCKFORD
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State | IL
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Zip | 61109-2604
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Country | US
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Telephone | 815-874-8000
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Fax | 815-874-7525
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Provider Business Mailing Address
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Address Line | PO BOX 500
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City | ELLICOTTVILLE
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State | NY
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Zip | 14731-0500
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Country | US
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Telephone | 716-699-9032
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROBERT BIERNBAUM
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Credential | DO
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Telephone | 585-430-8600
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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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