Provider Demographics
NPI:1164627782
Name:ASPEN URGENT CARE, LTD.
Entity Type:Organization
Organization Name:ASPEN URGENT CARE, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:PEYTON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:7334-854-1800
Mailing Address - Street 1:7581 SECOR RD
Mailing Address - Street 2:
Mailing Address - City:LAMBERTVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48144-9624
Mailing Address - Country:US
Mailing Address - Phone:734-854-1800
Mailing Address - Fax:734-856-6364
Practice Address - Street 1:7581 SECOR RD
Practice Address - Street 2:
Practice Address - City:LAMBERTVILLE
Practice Address - State:MI
Practice Address - Zip Code:48144-9624
Practice Address - Country:US
Practice Address - Phone:734-854-1800
Practice Address - Fax:734-856-6364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-15
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2590101Medicaid
MI080E811050OtherMICHIGAN BCBS/BCN
MI1164627782Medicaid
MI04855OtherPARAMOUNT
MI0P53250Medicare PIN