Provider Demographics
NPI:1184008070
Name:DR MELISSA GARGASZ URGENT CARE LLC
Entity Type:Organization
Organization Name:DR MELISSA GARGASZ URGENT CARE LLC
Other - Org Name:WAYNESVILLE URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:A
Authorized Official - Last Name:GARGASZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:513-855-4336
Mailing Address - Street 1:4353 E STATE ROUTE 73
Mailing Address - Street 2:SUITE 150
Mailing Address - City:WAYNESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45068-8812
Mailing Address - Country:US
Mailing Address - Phone:513-855-4336
Mailing Address - Fax:513-855-4436
Practice Address - Street 1:4353 E STATE ROUTE 73
Practice Address - Street 2:SUITE 150
Practice Address - City:WAYNESVILLE
Practice Address - State:OH
Practice Address - Zip Code:45068-8812
Practice Address - Country:US
Practice Address - Phone:513-855-4336
Practice Address - Fax:513-855-4436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-10
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care