Provider Demographics
NPI:1053093682
Name:VILLAGE URGENT CARE
Entity type:Organization
Organization Name:VILLAGE URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:WALTON
Authorized Official - Middle Name:CALLEN
Authorized Official - Last Name:WALLS
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:334-539-7761
Mailing Address - Street 1:1747 OGLETREE RD STE B
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-6648
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1747 OGLETREE RD STE B
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-6648
Practice Address - Country:US
Practice Address - Phone:334-412-2576
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1073172805OtherNPPES
AL1982816724OtherNPPES
AL1154791390OtherNPPES