1598793689 NPI number — URGENT CARE OF WEST CHESTER LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598793689 NPI number — URGENT CARE OF WEST CHESTER LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
URGENT CARE OF WEST CHESTER LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
WEST CHESTER URGENT CARE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598793689
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/28/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 76009
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HIGHLAND HEIGHTS
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
41076-0009
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-531-1555
Provider Business Mailing Address Fax Number:
513-531-2068

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7345 KINGSGATE WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST CHESTER
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45069-2453
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-531-1555
Provider Business Practice Location Address Fax Number:
513-531-2068
Provider Enumeration Date:
06/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
QURESHI
Authorized Official First Name:
MAJID
Authorized Official Middle Name:
A
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
513-531-1555

Provider Taxonomy Codes

  • Taxonomy code: 207PE0004X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2378430 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com