Provider Demographics
NPI:1972529857
Name:EMERGENCY MEDICAL CENTER, INC
Entity type:Organization
Organization Name:EMERGENCY MEDICAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:ECKEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-331-4357
Mailing Address - Street 1:6121 NW 1ST PL
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-2093
Mailing Address - Country:US
Mailing Address - Phone:352-331-4357
Mailing Address - Fax:
Practice Address - Street 1:6121 NW 1ST PL
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-2093
Practice Address - Country:US
Practice Address - Phone:352-331-4357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLB902LOtherBLUE CROSS PROVIDER NUMBE