Healthcare Provider Details

I. General information

NPI: 1972429447
Provider Name (Legal Business Name): CODELOGIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 S LEXINGTON ST STE 100
HARRISONVILLE MO
64701-2443
US

IV. Provider business mailing address

117 S LEXINGTON ST STE 100
HARRISONVILLE MO
64701-2443
US

V. Phone/Fax

Practice location:
  • Phone: 816-793-0550
  • Fax:
Mailing address:
  • Phone: 816-793-0550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NASIR MEHMOOD
Title or Position: OWNER
Credential:
Phone: 816-793-0550