MEDICARE: URGENT CARE SPECIALISTS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QU0200X	Urgent Care Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114957123
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	URGENT CARE SPECIALISTS, LLC

Provider Business Mailing Address
First Line	:	1430 OAK CT STE 100
Second Line	:
City	:	BEAVERCREEK
State	:	OH
Zip	:	45430-1064
Country	:	US
Telephone Number	:	937-236-8635
Fax Number	:	937-236-8630

Provider Business Practice Location Address
First Line	:	6210 BRANDT PIKE STE 102
Second Line	:
City	:	HUBER HEIGHTS
State	:	OH
Zip	:	45424-4019
Country	:	US
Telephone Number	:	937-236-8635
Fax Number	:	937-236-8630

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MANOJ KUMAR
Credential	:
Telephone Number	:	937-603-1941

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	04/22/2024

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