Organization
CONNECTICUT URGENT CARE CENTERS, LLC
Active
Other names
Connecticut Urgent Care Centers
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA K GALLACHER (ADMINISTRATOR)
(860) 378-8585
Entity
Organization
Contact information
Practice address
136 BERLIN RD, CROMWELL, CT 06416-2627
(860) 378-8585
(860) 378-8586
Mailing address
136 BERLIN RD, CROMWELL, CT 06416-2627
(860) 378-8585
(860) 378-8586
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
CT
207R00000X
Internal Medicine Physician
—
CT
208D00000X
General Practice Physician
Primary
—
—
261Q00000X
Clinic/Center
0739
CT
261QU0200X
Urgent Care Clinic/Center
—
CT
363A00000X
Physician Assistant
—
CT
363L00000X
Nurse Practitioner
—
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008056570
—
CT
01
—
07D2075714
CLIA
CT
01
—
D100187528
MEDICARE GROUP PTAN
CT
Enumeration date
03/05/2014
Last updated
05/26/2015
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