Provider Demographics
NPI:1114957123
Name:URGENT CARE SPECIALISTS, LLC
Entity Type:Organization
Organization Name:URGENT CARE SPECIALISTS, LLC
Other - Org Name:HOMETOWN URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MANOJ
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-603-1941
Mailing Address - Street 1:1430 OAK CT STE 100
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45430-1064
Mailing Address - Country:US
Mailing Address - Phone:937-236-8635
Mailing Address - Fax:937-236-8630
Practice Address - Street 1:6210 BRANDT PIKE STE 102
Practice Address - Street 2:
Practice Address - City:HUBER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:45424-4019
Practice Address - Country:US
Practice Address - Phone:937-236-8635
Practice Address - Fax:937-236-8630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2630700Medicaid
OHUR9358461Medicare PIN
OHUR9358461Medicare PIN