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General NPI Number Information
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NPI Number | 1750665261
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Entity Type | Organization
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Legal Business Name | GRANBY URGENT CARE LLC
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Dates
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Enumeration Date | 10/03/2011
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Last Update Date | 02/03/2015
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Provider Practice Location Address
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Address Line | 7 MILL POND RD
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City | GRANBY
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State | CT
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Zip | 06035-2637
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Country | US
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Telephone | 860-653-2382
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Fax | 860-653-6235
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Provider Business Mailing Address
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Address Line | 7 MILL POND RD
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City | GRANBY
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State | CT
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Zip | 06035-2637
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Country | US
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Telephone | 860-653-2382
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Fax | 860-653-6235
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | MRS. BARBARA KEI
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Credential |
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Telephone | 860-653-2382
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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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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