| NPI | 1801563366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANGAIYAKKARASI SIVAKUMAR Owner 888-460-1151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center Urgent Care |
| Additional Taxonomies | 207P00000X Emergency Medicine |
| 207Q00000X Family Medicine | |
| 261QA1903X Clinic/Center Ambulatory Surgical | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 261QR0200X Clinic/Center Radiology | |
| 291U00000X Clinical Medical Laboratory | |
| 333300000X Emergency Response System Companies | |
| 333600000X Pharmacy | |
| Enumeration Date | 2021-08-24 |
| Last Update Date | 2022-01-21 |