Organization
PROVIDENCE URGENT CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUANITA D ROY (VP FINANCE)
(913) 596-4000
Entity
Organization
Contact information
Practice address
22334 W 66TH ST SPC 10, SHAWNEE, KS 66226-3560
(913) 825-0909
(913) 825-0905
Mailing address
8929 PARALLEL PKWY, KANSAS CITY, KS 66112-1689
(913) 596-4000
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36051011
BLUE CROSS BLUE SHIELD GR
KS
Enumeration date
07/17/2006
Last updated
07/21/2022
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