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NPI Code Detail

MEDICARE: WALK IN CLINIC LLC

MEDICARE: WALK IN CLINIC 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
1261Q00000XClinic/CenterRN214125OH

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 : 1356631535
Entity Type Code : Organization
Provider Name (Legal Business Name) : WALK IN CLINIC LLC
Provider Business Mailing Address
First Line : 207 W HIGH ST
Second Line :
City : MOUNT VERNON
State : OH
Zip : 43050-2427
Country : US
Telephone Number : 740-392-0911
Fax Number :
Provider Business Practice Location Address
First Line : 207 W HIGH ST
Second Line :
City : MOUNT VERNON
State : OH
Zip : 43050-2427
Country : US
Telephone Number : 740-392-0911
Fax Number :
Authorized Official
Title or Position : CNP
Name : PHYLLIS ANN SIM
Credential : MSN
Telephone Number : 740-397-2655
Provider Enumeration Date : 04/08/2011
Last Update Date : 10/18/2012

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Directions to “WALK IN CLINIC LLC ” Practice Location

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