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NPI Code Detail

MEDICARE: TENET UNIFOUR URGENT CARE CENTER LLC

MEDICARE: TENET UNIFOUR URGENT CARE CENTER 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/Center

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2CG6339OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
101766OTHERNCBCBS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528055621
Entity Type Code : Organization
Provider Name (Legal Business Name) : TENET UNIFOUR URGENT CARE CENTER LLC
Provider Business Mailing Address
First Line : P.O. BOX 741330
Second Line :
City : ATLANTA
State : GA
Zip : 30384-1330
Country : US
Telephone Number : 828-267-0551
Fax Number : 828-267-0351
Provider Business Practice Location Address
First Line : 1105 FAIRGROVE CHURCH RD SE
Second Line :
City : CONOVER
State : NC
Zip : 28613-9090
Country : US
Telephone Number : 828-267-0551
Fax Number : 828-267-0351
Authorized Official
Title or Position : SVP OF OUTPATIENT SERVICES, TENET
Name : MR. MICHAEL KYLE BURTNETT
Credential :
Telephone Number : 469-893-2153
Provider Enumeration Date : 10/04/2005
Last Update Date : 07/28/2016

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Directions to “TENET UNIFOUR URGENT CARE CENTER LLC ” Practice Location

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