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General NPI Number Information
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NPI Number | 1891250643
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Entity Type | Organization
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Legal Business Name | FAMILY URGENT CARE LLC
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Dates
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Enumeration Date | 02/06/2019
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Last Update Date | 02/06/2019
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Provider Practice Location Address
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Address Line | 1860 SOUTH MAIN STREET
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City | BELLEFONTAINE
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State | OH
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Zip | 43311-9997
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Country | US
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Telephone | 937-592-0731
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Fax | 937-592-0727
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Provider Business Mailing Address
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Address Line | 879 N BRIDGE ST
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City | CHILLICOTHEE
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State | OH
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Zip | 45601-1704
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Country | US
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Telephone | 740-772-5050
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Fax |
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Authorized Official
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Title or Position | REGIONAL MANAGER
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Name | LESIA SEDORIS
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Credential |
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Telephone | 937-450-1244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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