Provider Demographics
NPI:1053781914
Name:TRINITY URGENT CARE LLC
Entity type:Organization
Organization Name:TRINITY URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLEES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-550-5277
Mailing Address - Street 1:1460 TRINITY DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:LOS ALAMOS
Mailing Address - State:NM
Mailing Address - Zip Code:87544-4106
Mailing Address - Country:US
Mailing Address - Phone:505-412-6033
Mailing Address - Fax:505-412-6032
Practice Address - Street 1:1460 TRINITY DR
Practice Address - Street 2:SUITE A
Practice Address - City:LOS ALAMOS
Practice Address - State:NM
Practice Address - Zip Code:87544-4106
Practice Address - Country:US
Practice Address - Phone:505-412-6033
Practice Address - Fax:505-412-6032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-04
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD20060791261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care