Provider Demographics
NPI:1346298189
Name:URGENT CARE, INC.
Entity type:Organization
Organization Name:URGENT CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:JAHANI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:970-874-9977
Mailing Address - Street 1:164 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:DELTA
Mailing Address - State:CO
Mailing Address - Zip Code:81416-1842
Mailing Address - Country:US
Mailing Address - Phone:970-874-2691
Mailing Address - Fax:970-874-9952
Practice Address - Street 1:2305 S TOWNSEND AVE
Practice Address - Street 2:UNIT B
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-5487
Practice Address - Country:US
Practice Address - Phone:970-249-2254
Practice Address - Fax:970-252-0852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO06D1050216OtherCLIA
CO95351281Medicaid
CO=========OtherFEIN
COC805508Medicare PIN