Provider Demographics
NPI:1306927389
Name:ADVANCED URGENT CARE, P.C.
Entity type:Organization
Organization Name:ADVANCED URGENT CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/M.D.
Authorized Official - Prefix:MS
Authorized Official - First Name:REEMA
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHAUDRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:571-261-4165
Mailing Address - Street 1:7200 HERITAGE VILLAGE PLZ
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-3069
Mailing Address - Country:US
Mailing Address - Phone:571-261-4165
Mailing Address - Fax:571-261-4166
Practice Address - Street 1:7200 HERITAGE VILLAGE PLZ
Practice Address - Street 2:SUITE 101
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-3069
Practice Address - Country:US
Practice Address - Phone:571-261-4165
Practice Address - Fax:571-261-4166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC09667Medicare PIN