NPI | 1912950148 |
---|---|
Doing Business As | MAT-SU REGIONAL URGENT CARE |
Entity Type | Organization |
Authorized Contact | JENNIFER L JACKSON Sr Director Provider Enrollment Cvs 615-465-3334 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261Q00000X Clinic/Center (Licence: AK 299454) |
Additional Taxonomies | 207R00000X Internal Medicine |
261QU0200X Clinic/Center, Urgent Care | |
Enumeration Date | 2006-05-18 |
Last Update Date | 2023-06-18 |