Basic Information
| Provider Information | |||||||||
| NPI: | 1528662491 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MOUNT CARMEL URGENT CARE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 EAST CAMPBELL RD | ||||||||
| Address2: | SUITE 108 - LOCKBOX #676236 | ||||||||
| City: | RICHARDSON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750812730 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 6599 E BROAD ST | ||||||||
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| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432131509 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6143558150 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/23/2020 | ||||||||
| LastUpdateDate: | 04/04/2022 | ||||||||
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| AuthorizedOfficialLastName: | SAMSON | ||||||||
| AuthorizedOfficialFirstName: | TAMARA | ||||||||
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| AuthorizedOfficialTitleorPosition: | VP - REVENUE CYCLE | ||||||||
| AuthorizedOfficialTelephone: | 2252397190 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 04/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QU0200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
No ID Information.