Provider Demographics
NPI:1902352131
Name:RIVER CITIES URGENT CARE LLC
Entity Type:Organization
Organization Name:RIVER CITIES URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRENNAN
Authorized Official - Middle Name:
Authorized Official - Last Name:UTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-706-3033
Mailing Address - Street 1:2762 CONTINENTAL DR
Mailing Address - Street 2:STE 201
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-3240
Mailing Address - Country:US
Mailing Address - Phone:225-706-3033
Mailing Address - Fax:
Practice Address - Street 1:5314 AIRLINE DR
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-6711
Practice Address - Country:US
Practice Address - Phone:318-678-5272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-28
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care