# IMMEDIATE CARE OF ROME \#1, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144552423
- **Authorized official:** ROBERT WILDMON (COO)
- **Authorized official phone:** (706) 354-1036

## Contact information

- **Practice address:** 18 RIVERBEND DR SW, SUITE 230, ROME, GA 30161-6013
- **Practice address phone:** (706) 291-2999
- **Practice address fax:** (706) 291-4006
- **Mailing address:** 18 RIVERBEND DR SW, SUITE 230, ROME, GA 30161-6013
- **Mailing address phone:** (706) 291-2999
- **Mailing address fax:** (706) 291-4006

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | RN113917 | GA | Yes |

## Other

- **Enumeration date:** 02/11/2010
- **Last updated:** 02/11/2010