Provider Demographics
NPI:1528874765
Name:NEWBURGH URGENT CARE LLC
Entity type:Organization
Organization Name:NEWBURGH URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCNULTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-663-0955
Mailing Address - Street 1:3245 MOUNT MORIAH AVE STE 10
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-7834
Mailing Address - Country:US
Mailing Address - Phone:270-663-0955
Mailing Address - Fax:
Practice Address - Street 1:607 W 6TH STREET
Practice Address - Street 2:STE B
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-2628
Practice Address - Country:US
Practice Address - Phone:812-803-3775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-03
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy