Provider Demographics
NPI:1104515196
Name:RENEWED MEDICAL HEALTH URGENT CARE, LLC
Entity type:Organization
Organization Name:RENEWED MEDICAL HEALTH URGENT CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BEATE
Authorized Official - Middle Name:
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-777-7831
Mailing Address - Street 1:2825 E BROADWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-5309
Mailing Address - Country:US
Mailing Address - Phone:520-298-0005
Mailing Address - Fax:520-777-7832
Practice Address - Street 1:514 E WHITEHOUSE CANYON RD STE 110
Practice Address - Street 2:
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-0539
Practice Address - Country:US
Practice Address - Phone:520-777-7831
Practice Address - Fax:520-777-7832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-04
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care