Provider Demographics
NPI:1063855294
Name:MT. AUBURN URGENT CARE, LLC
Entity Type:Organization
Organization Name:MT. AUBURN URGENT CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:BRADFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-772-9065
Mailing Address - Street 1:2230 AUBURN AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2975
Mailing Address - Country:US
Mailing Address - Phone:513-621-2200
Mailing Address - Fax:513-620-8993
Practice Address - Street 1:2230 AUBURN AVE
Practice Address - Street 2:SUITE B
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2975
Practice Address - Country:US
Practice Address - Phone:513-621-0007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-08
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty