Organization
URGENT CARE OF LONG BEACH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LYDIA K RAYNER (OWNER)
(228) 864-0622
Entity
Organization
Contact information
Practice address
200 W RAILROAD ST, LONG BEACH, MS 39560-4517
(228) 864-0622
(228) 864-7958
Mailing address
200 W RAILROAD ST, P O BOX 869, LONG BEACH, MS 39560-4517
(228) 864-0622
(228) 864-7958
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09879396
—
MS
Enumeration date
05/25/2007
Last updated
01/03/2014
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