Provider Demographics
NPI:1114450764
Name:SHC YOUNGSTOWN OHIO OUTPATIENT SERVICES LLC
Entity Type:Organization
Organization Name:SHC YOUNGSTOWN OHIO OUTPATIENT SERVICES LLC
Other - Org Name:URGENT CARE AUSTINTOWN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER / DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:RICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-884-1500
Mailing Address - Street 1:20 OHLTOWN RD
Mailing Address - Street 2:
Mailing Address - City:AUSTINTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-2331
Mailing Address - Country:US
Mailing Address - Phone:330-884-1500
Mailing Address - Fax:
Practice Address - Street 1:20 OHLTOWN RD
Practice Address - Street 2:
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-2331
Practice Address - Country:US
Practice Address - Phone:330-884-1500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-10
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care