Organization
GREAT MEDICAL LLC
Active
Organization
GREAT MEDICAL LLC
Active
Other names
Complete COVID-19 Testing Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES JEROD WILLIAMS JR. REGISTERED NURSE (OWNER)
(919) 939-5111
Entity
Organization
Contact information
Practice address
9591 FOOTHILL BLVD, RANCHO CUCAMONGA, CA 91730-3506
(909) 747-4531
Mailing address
1508 BARTON RD # 116, REDLANDS, CA 92373-1410
(919) 939-5111
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
02/19/2021
Last updated
02/19/2021
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