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Organization
COMMUNITY URGENT CARE CENTER, LLC
Active
Organization
COMMUNITY URGENT CARE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LINDA S TUCKER APRN (MANAGING MEMBER)
(812) 989-2564
Entity
Organization
Contact information
Practice address
927 E BROADWAY STE B, LOUISVILLE, KY 40204-1001
(502) 749-2900
Mailing address
927 E BROADWAY STE B, LOUISVILLE, KY 40204-1001
(502) 749-2900
Taxonomy
Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
3006536P
KY
261QU0200X
Urgent Care Clinic/Center
Primary
3006536P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K020650
MEDICARE PTAN
—
Enumeration date
01/25/2012
Last updated
02/17/2012
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