Providence Immediate Care Incorporated
NPI #1871816884 in Villa Rica, Georgia
Provider Information
- NPI Number
- 1871816884
- Entity Type
- Organization
- Organization Name
- Providence Immediate Care Incorporated
- Primary Specialty
- Clinic/Center - Urgent Care
- Enumeration Date
- Mar 4, 2010
- Last Updated
- Mar 4, 2010
Practice Location
- Address
- 1002 OVERLOOK DR
- City
- Villa Rica
- State
- Georgia
- ZIP Code
- 30180-5804
- Phone
- (678) 907-2086
Authorized Official
- Name
- DR. EWANE NGONE, M.D.
- Title
- PRESIDENT/CEO
- Phone
- (678) 907-2086
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Urgent Care — Urgent Care |
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