Organization
EAST VALLEY URGENT CARE,LLC
Active
Other names
Urgent Care Extra-Val Vista
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA GRONBERG RN (SENIOR EXECUTIVE VP OPERATIONS)
(480) 840-3075
Entity
Organization
Contact information
Practice address
1641 E GUADALUPE RD, GILBERT, AZ 85233
(480) 840-3075
Mailing address
3336 E CHANDLER HEIGHTS RD, STE 121, GILBERT, AZ 85298
(480) 840-3075
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
83288
MEDICARE ID-TYPE UNSPECIFIED
—
Enumeration date
10/03/2012
Last updated
10/03/2012
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