Organization
TRI-CITY EXPRESS CARE PLLC
Active
Other names
FastMed Urgent Care
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL DUNN MD (CMO)
(480) 545-2787
Entity
Organization
Contact information
Practice address
1507 N LITCHFIELD RD, GOODYEAR, AZ 85395-1237
(623) 215-0040
(623) 535-3397
Mailing address
890 W ELLIOT RD, SUITE 103, GILBERT, AZ 85233-5102
(480) 545-2787
(480) 545-1434
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
712139
—
AZ
01
—
OTC5412
STATE LICENSE NUMBER
AZ
Enumeration date
05/17/2012
Last updated
05/23/2013
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