Provider Demographics
NPI:1215388145
Name:FAMILY CHOICE URGENT CARE LLC
Entity Type:Organization
Organization Name:FAMILY CHOICE URGENT CARE LLC
Other - Org Name:FAMILY CHOICE URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:MUCHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:541-213-2133
Mailing Address - Street 1:108 NW SISEMORE ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-2869
Mailing Address - Country:US
Mailing Address - Phone:541-213-2133
Mailing Address - Fax:
Practice Address - Street 1:108 NW SISEMORE ST
Practice Address - Street 2:SUITE 120
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-2869
Practice Address - Country:US
Practice Address - Phone:541-213-2133
Practice Address - Fax:541-640-8107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-22
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care