Provider Demographics
NPI:1386240539
Name:TELE URGENT CARE OF AMERICA
Entity type:Organization
Organization Name:TELE URGENT CARE OF AMERICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHARITY
Authorized Official - Middle Name:
Authorized Official - Last Name:BURDEN
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:706-705-2621
Mailing Address - Street 1:1505 WATER SHINE WAY
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-7765
Mailing Address - Country:US
Mailing Address - Phone:706-705-2621
Mailing Address - Fax:
Practice Address - Street 1:1505 WATER SHINE WAY
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-7765
Practice Address - Country:US
Practice Address - Phone:706-701-2621
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service