Provider Demographics
NPI:1255727897
Name:GOLD CROSS URGENT CARE, LLC
Entity type:Organization
Organization Name:GOLD CROSS URGENT CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COE
Authorized Official - Prefix:MRS
Authorized Official - First Name:EZINNE
Authorized Official - Middle Name:C
Authorized Official - Last Name:NWUDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-859-2920
Mailing Address - Street 1:100 E CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:AR
Mailing Address - Zip Code:71730-4602
Mailing Address - Country:US
Mailing Address - Phone:870-862-2331
Mailing Address - Fax:
Practice Address - Street 1:100 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730-4602
Practice Address - Country:US
Practice Address - Phone:870-510-1281
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-10
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care