Healthcare Provider Details

I. General information

NPI: 1508277237
Provider Name (Legal Business Name): NORTHWEST OHIO URGENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2014
Last Update Date: 05/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1421 S REYNOLDS RD
TOLEDO OH
43615-7413
US

IV. Provider business mailing address

1421 S REYNOLDS RD
TOLEDO OH
43615-7413
US

V. Phone/Fax

Practice location:
  • Phone: 419-725-6290
  • Fax: 419-725-6287
Mailing address:
  • Phone: 419-725-6290
  • Fax: 419-725-6287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35081708
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35067481
License Number StateOH

VIII. Authorized Official

Name: ARSHAD HUSAIN
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 419-725-6290