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NPI Code Detail

MEDICARE: NORTH OLMSTED URGENT CARE, LLC

MEDICARE: NORTH OLMSTED URGENT CARE, LLC
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
1207Q00000XFamily Medicine Physician34009045OH
2261QU0200XUrgent Care Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104115427
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTH OLMSTED URGENT CARE, LLC
Provider Business Mailing Address
First Line : PO BOX 770920
Second Line :
City : LAKEWOOD
State : OH
Zip : 44107-0041
Country : US
Telephone Number : 440-471-7083
Fax Number : 440-471-7113
Provider Business Practice Location Address
First Line : 25757 LORAIN RD
Second Line :
City : NORTH OLMSTED
State : OH
Zip : 44070-3370
Country : US
Telephone Number : 440-471-7083
Fax Number : 440-471-7113
Authorized Official
Title or Position : OWNER
Name : DR. NICOLAS A YOUNG
Credential : DO
Telephone Number : 440-471-7083
Provider Enumeration Date : 04/07/2011
Last Update Date : 12/11/2016

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Directions to “NORTH OLMSTED URGENT CARE, LLC ” Practice Location

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