Basic Information
| Provider Information | |||||||||
| NPI: | 1457802019 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | URGENT CARE CENTERS OF ARIZONA, LLC | ||||||||
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| OtherOrganizationName: | MEDPOST URGENT CARE - LITCHFIELD PARK | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 115 EASTPARK DR | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | BRENTWOOD | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370277548 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6156024102 | ||||||||
| FaxNumber: | 6153098341 | ||||||||
| Practice Location | |||||||||
| Address1: | 13840 W. CAMELBACK RD | ||||||||
| Address2: | SUITE 10 | ||||||||
| City: | LITCHFIELD PARK | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85340 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9283238112 | ||||||||
| FaxNumber: | 9283238113 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/19/2016 | ||||||||
| LastUpdateDate: | 10/19/2016 | ||||||||
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| AuthorizedOfficialLastName: | ENDERLE | ||||||||
| AuthorizedOfficialFirstName: | ERIC | ||||||||
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| AuthorizedOfficialTitleorPosition: | AUTHORIZED SIGNATORY | ||||||||
| AuthorizedOfficialTelephone: | 6156004120 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QU0200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
No ID Information.