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Organization
PROVIDENCE IMMEDIATE CARE INCORPORATED
Active
Organization
PROVIDENCE IMMEDIATE CARE INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EWANE NGONE M.D. (PRESIDENT/CEO)
(678) 907-2086
Entity
Organization
Contact information
Practice address
1002 OVERLOOK DR, VILLA RICA, GA 30180-5804
(678) 907-2086
(678) 840-8742
Mailing address
1002 OVERLOOK DR, VILLA RICA, GA 30180-5804
(678) 907-2086
(678) 840-8742
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Enumeration date
03/04/2010
Last updated
03/04/2010
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