Provider Demographics
NPI:1144824699
Name:HOLY CROSS URGENT CARE
Entity type:Organization
Organization Name:HOLY CROSS URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP - REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-239-7190
Mailing Address - Street 1:4100 W 150TH ST
Mailing Address - Street 2:LOCKBOX# 932536
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44135-1304
Mailing Address - Country:US
Mailing Address - Phone:225-239-7190
Mailing Address - Fax:
Practice Address - Street 1:1115 S FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-1256
Practice Address - Country:US
Practice Address - Phone:954-764-6646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-25
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care