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Organization
UCXTRA UMBRELLA, LLC
Active
Organization
UCXTRA UMBRELLA, LLC
Active
Other names
Urgent Care Extra AZ
Organization subpart
No
Provider details
NPI number
Authorized official
AMY PANDURO (CHIEF ADMIN OFFICER)
(480) 663-2432
Entity
Organization
Contact information
Practice address
1250 S CLEARVIEW AVE, SUITE 100, MESA, AZ 85209
(480) 988-9108
Mailing address
35945 N GARY RD, SAN TAN VALLEY, AZ 85143
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
412931
—
AZ
Enumeration date
07/18/2015
Last updated
07/20/2015
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