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General NPI Number Information
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NPI Number | 1669694915
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Entity Type | Organization
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Legal Business Name | IMPRIMIS HEALTHCARE
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1911 N PINE ISLAND RD
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City | SUNRISE
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State | FL
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Zip | 33322-5210
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Country | US
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Telephone | 954-916-5211
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Fax | 954-916-3846
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Provider Business Mailing Address
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Address Line | 1911 N PINE ISLAND RD
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City | SUNRISE
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State | FL
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Zip | 33322-5210
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Country | US
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Telephone | 954-916-5211
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Fax | 954-916-3846
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MRS. JACQUELINE L WILLOUGHBY
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Credential |
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Telephone | 954-916-5211
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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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