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General NPI Number Information
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NPI Number | 1831463470
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Entity Type | Organization
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Legal Business Name | BEAUMONT URGENT CARE CLINIC
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Dates
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Enumeration Date | 02/29/2012
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Last Update Date | 02/29/2012
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Provider Practice Location Address
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Address Line | 2097 BEAUMONT DR
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City | BATON ROUGE
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State | LA
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Zip | 70806-1412
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Country | US
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Telephone | 225-394-5044
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Fax | 225-372-2609
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Provider Business Mailing Address
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Address Line | 2097 BEAUMONT DR
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City | BATON ROUGE
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State | LA
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Zip | 70806-1412
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Country | US
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Telephone | 225-394-5044
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Fax | 225-372-2609
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Authorized Official
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Title or Position | CEO
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Name | TAMMIE JACKSON
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Credential |
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Telephone | 225-394-5044
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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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