MEDICARE: HULIN URGENT CARE SERVICES 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

General Provider Information

NPI Number	:	1629665435
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HULIN URGENT CARE SERVICES LLC

Provider Business Mailing Address
First Line	:	600 JEFFERSON ST STE 600
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70501-6987
Country	:	US
Telephone Number	:	337-202-0720
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 HOSPITAL RD
Second Line	:
City	:	NEW ROADS
State	:	LA
Zip	:	70760-2621
Country	:	US
Telephone Number	:	225-310-6501
Fax Number	:	225-310-6502

Authorized Official
Title or Position	:	OWNER
Name	:	CLAYT W. HULIN
Credential	:
Telephone Number	:	337-465-4600

Provider Enumeration Date	:	12/28/2020
Last Update Date	:	01/06/2021

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