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NPI Code Detail

MEDICARE: APACHE JUNCTION URGENT CARE LLC

MEDICARE: APACHE JUNCTION URGENT CARE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QU0200XUrgent Care Clinic/CenterOTC3083AZ

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2CJ9159OTHERAZRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053375659
Entity Type Code : Organization
Provider Name (Legal Business Name) : APACHE JUNCTION URGENT CARE LLC
Provider Business Mailing Address
First Line : 1710 THISTLE RD
Second Line :
City : FLAGSTAFF
State : AZ
Zip : 86004-7739
Country : US
Telephone Number : 928-522-8006
Fax Number : 928-522-8556
Provider Business Practice Location Address
First Line : 2080 W SOUTHERN AVE
Second Line : STE. 1
City : APACHE JUNCTION
State : AZ
Zip : 85220-7455
Country : US
Telephone Number : 480-776-1588
Fax Number : 480-985-0173
Authorized Official
Title or Position : CEO
Name : JOHN SHUFELDT JR.
Credential : M.D.
Telephone Number : 480-924-8382
Provider Enumeration Date : 04/12/2006
Last Update Date : 01/24/2008

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Directions to “APACHE JUNCTION URGENT CARE LLC ” Practice Location

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