Basic Information
| Provider Information | |||||||||
| NPI: | 1497077978 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | M-URGENT CARE LLC | ||||||||
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| OtherOrganizationName: | INDIANA UNIVERSITY HEALTH URGENT CARE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4850 CENTURY PLAZA RD | ||||||||
| Address2: | SUITE 140 | ||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462545476 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3172162828 | ||||||||
| FaxNumber: | 3172162839 | ||||||||
| Practice Location | |||||||||
| Address1: | 11580 OVERLOOK DR | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | FISHERS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460374212 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3175675252 | ||||||||
| FaxNumber: | 3175675253 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/24/2010 | ||||||||
| LastUpdateDate: | 04/13/2011 | ||||||||
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| AuthorizedOfficialLastName: | BRINK | ||||||||
| AuthorizedOfficialFirstName: | THOMAS | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 3172162520 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2000X | N | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy | 261QU0200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
No ID Information.