MEDICARE: DOCTORS URGENT CARE OFFICE MEDICAL GROUP INC

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

General Provider Information

NPI Number	:	1639653777
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOCTORS URGENT CARE OFFICE MEDICAL GROUP INC

Provider Business Mailing Address
First Line	:	935 STATE ROUTE 28
Second Line	:
City	:	MILFORD
State	:	OH
Zip	:	45150-1957
Country	:	US
Telephone Number	:	513-831-5955
Fax Number	:	513-831-5985

Provider Business Practice Location Address
First Line	:	9232 READING RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45215-3416
Country	:	US
Telephone Number	:	513-831-5955
Fax Number	:	513-831-5985

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PAUL J AMRHEIN
Credential	:
Telephone Number	:	513-831-5955

Provider Enumeration Date	:	09/24/2018
Last Update Date	:	09/24/2018

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