Provider Demographics
NPI:1871893339
Name:URGENT CARE OF SLIDELL, INC.
Entity type:Organization
Organization Name:URGENT CARE OF SLIDELL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:A
Authorized Official - Last Name:GALLOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-726-9605
Mailing Address - Street 1:202 VILLAGE CIR STE 1
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-5374
Mailing Address - Country:US
Mailing Address - Phone:985-726-9605
Mailing Address - Fax:985-726-9633
Practice Address - Street 1:360 GATEWAY DR STE B
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70461-5540
Practice Address - Country:US
Practice Address - Phone:985-661-8851
Practice Address - Fax:985-661-8854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-29
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care