Provider Demographics
NPI:1548504053
Name:URGENT HEALTH CARE P.C.
Entity type:Organization
Organization Name:URGENT HEALTH CARE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:HOLLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:208-315-4390
Mailing Address - Street 1:PO BOX 2603
Mailing Address - Street 2:
Mailing Address - City:MCCALL
Mailing Address - State:ID
Mailing Address - Zip Code:83638-2603
Mailing Address - Country:US
Mailing Address - Phone:208-315-4390
Mailing Address - Fax:
Practice Address - Street 1:212 N 3RD ST
Practice Address - Street 2:SUITE B
Practice Address - City:MCCALL
Practice Address - State:ID
Practice Address - Zip Code:83638-4414
Practice Address - Country:US
Practice Address - Phone:208-315-4390
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-11371208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty