Provider Demographics
NPI:1538402573
Name:PREMIER URGENT CARE
Entity type:Organization
Organization Name:PREMIER URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:D
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-706-8986
Mailing Address - Street 1:307 ALCIDE DOMINIQUE DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-1052
Mailing Address - Country:US
Mailing Address - Phone:337-706-9100
Mailing Address - Fax:337-451-1300
Practice Address - Street 1:307 ALCIDE DOMINIQUE DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-1052
Practice Address - Country:US
Practice Address - Phone:337-706-9100
Practice Address - Fax:337-451-1300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-28
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty