Provider Demographics
NPI:1104910074
Name:MEDXCEL URGENT CARE LLC
Entity type:Organization
Organization Name:MEDXCEL URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:DESORMEAUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-893-0788
Mailing Address - Street 1:2325 CHARITY ST
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70510-4018
Mailing Address - Country:US
Mailing Address - Phone:337-893-0788
Mailing Address - Fax:337-893-0787
Practice Address - Street 1:2325 CHARITY ST
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70510-4018
Practice Address - Country:US
Practice Address - Phone:337-893-0788
Practice Address - Fax:337-893-0787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty