Provider Demographics
NPI:1902399249
Name:CALCASIEU URGENT CARE LLC
Entity Type:Organization
Organization Name:CALCASIEU URGENT CARE LLC
Other - Org Name:JENNINGS URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-426-0919
Mailing Address - Street 1:1750 ELTON RD
Mailing Address - Street 2:
Mailing Address - City:JENNINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70546
Mailing Address - Country:US
Mailing Address - Phone:337-329-6565
Mailing Address - Fax:337-329-6575
Practice Address - Street 1:1750 ELTON RD
Practice Address - Street 2:
Practice Address - City:JENNINGS
Practice Address - State:LA
Practice Address - Zip Code:70546
Practice Address - Country:US
Practice Address - Phone:337-329-6565
Practice Address - Fax:337-329-6575
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CALCASIEU URGENT CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-06-12
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care