Provider Demographics
NPI:1093384398
Name:COMPASSIONATE FAMILY URGENT CARE LLC
Entity Type:Organization
Organization Name:COMPASSIONATE FAMILY URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:E
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:JR
Authorized Official - Credentials:APRN CNP
Authorized Official - Phone:405-206-8192
Mailing Address - Street 1:1216 SW 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MINCO
Mailing Address - State:OK
Mailing Address - Zip Code:73059-3046
Mailing Address - Country:US
Mailing Address - Phone:405-206-8192
Mailing Address - Fax:
Practice Address - Street 1:1100 SW 3RD ST
Practice Address - Street 2:
Practice Address - City:MINCO
Practice Address - State:OK
Practice Address - Zip Code:73059-7305
Practice Address - Country:US
Practice Address - Phone:405-206-8192
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-21
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care