Healthcare Provider Details

I. General information

NPI: 1790030385
Provider Name (Legal Business Name): HOMETOWN URGENT CARE OF MICHIGAN, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2012
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6210 BRANDT PIKE
HUBER HEIGHTS OH
45424-4019
US

IV. Provider business mailing address

PO BOX 500
ELLICOTTVILLE NY
14731-0500
US

V. Phone/Fax

Practice location:
  • Phone: 937-236-8630
  • Fax: 937-236-8635
Mailing address:
  • Phone: 716-699-9032
  • 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: DR. JOHN C RADFORD
Title or Position: OWNER
Credential: MD
Phone: 716-699-9032