Organization
UCXTRA UMBRELLA, LLC
Active
Other names
Urgent Care Extra AZ
Organization subpart
No
Provider details
NPI number
Authorized official
AMY PANDURO (CHIEF ADMIN OFFICER)
(480) 663-2432
Entity
Organization
Contact information
Practice address
1250 S CLEARVIEW AVE, SUITE 100, MESA, AZ 85209
(480) 988-9108
Mailing address
35945 N GARY RD, SAN TAN VALLEY, AZ 85143
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
412931
—
AZ
Enumeration date
07/18/2015
Last updated
07/20/2015
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