Provider Demographics
NPI:1083380315
Name:MIDWEST TOTAL URGENT CARE, LLC
Entity Type:Organization
Organization Name:MIDWEST TOTAL URGENT CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:LANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:BESAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-768-6986
Mailing Address - Street 1:8 N FRENCH LN
Mailing Address - Street 2:
Mailing Address - City:PERRYVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63775-1577
Mailing Address - Country:US
Mailing Address - Phone:573-768-6986
Mailing Address - Fax:949-655-8621
Practice Address - Street 1:8 N FRENCH LN
Practice Address - Street 2:
Practice Address - City:PERRYVILLE
Practice Address - State:MO
Practice Address - Zip Code:63775-1577
Practice Address - Country:US
Practice Address - Phone:573-768-6986
Practice Address - Fax:949-655-8621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-17
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
1841748084OtherNPPES
1154760031OtherNPPES
1841243565OtherNPPES
1063039311OtherNPPES