MEDICARE: THE URGENT CARE CENTER OF RICHMOND HILL, 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	261QX0100X	Occupational Medicine Clinic/Center
2	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1821233354
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE URGENT CARE CENTER OF RICHMOND HILL, LLC

Provider Business Mailing Address
First Line	:	60 EXCHANGE ST STE B7
Second Line	:
City	:	RICHMOND HILL
State	:	GA
Zip	:	31324-7646
Country	:	US
Telephone Number	:	912-756-2273
Fax Number	:	912-756-3773

Provider Business Practice Location Address
First Line	:	60 EXCHANGE ST STE B7
Second Line	:
City	:	RICHMOND HILL
State	:	GA
Zip	:	31324-7646
Country	:	US
Telephone Number	:	912-756-2273
Fax Number	:	912-756-3773

Authorized Official
Title or Position	:	OWNER
Name	:	CATHERINE CORISH GRANT
Credential	:	PA-C
Telephone Number	:	912-756-2273

Provider Enumeration Date	:	12/12/2008
Last Update Date	:	08/30/2021

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