MEDICARE: GOLD CROSS 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
1	261QU0200X	Urgent Care Clinic/Center		AR

General Provider Information

NPI Number	:	1255727897
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLD CROSS URGENT CARE, LLC

Provider Business Mailing Address
First Line	:	100 E CHURCH ST
Second Line	:
City	:	EL DORADO
State	:	AR
Zip	:	71730-4602
Country	:	US
Telephone Number	:	870-862-2331
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 E CHURCH ST
Second Line	:
City	:	EL DORADO
State	:	AR
Zip	:	71730-4602
Country	:	US
Telephone Number	:	870-510-1281
Fax Number	:

Authorized Official
Title or Position	:	COE
Name	:	MRS. EZINNE C NWUDE
Credential	:	M.D.
Telephone Number	:	516-859-2920

Provider Enumeration Date	:	04/10/2015
Last Update Date	:	05/03/2024

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