Provider Demographics
NPI:1992105787
Name:IMMEDIATE CARE INC.
Entity type:Organization
Organization Name:IMMEDIATE CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-230-3295
Mailing Address - Street 1:4851 E BLUE LUPINE DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-8411
Mailing Address - Country:US
Mailing Address - Phone:907-357-4387
Mailing Address - Fax:907-357-4397
Practice Address - Street 1:4851 E BLUE LUPINE DR
Practice Address - Street 2:SUITE B
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-8411
Practice Address - Country:US
Practice Address - Phone:907-357-4387
Practice Address - Fax:907-357-4397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-28
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health