Provider Demographics
NPI:1235428343
Name:BUTTERMILK URGENT CARE LLC
Entity Type:Organization
Organization Name:BUTTERMILK URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:THORAYA
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:513-531-1505
Mailing Address - Street 1:4060 CLIFTON RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45220-1146
Mailing Address - Country:US
Mailing Address - Phone:513-218-2848
Mailing Address - Fax:513-531-2068
Practice Address - Street 1:525 CLOCK TOWER WAY
Practice Address - Street 2:
Practice Address - City:FORT MITCHELL
Practice Address - State:KY
Practice Address - Zip Code:41017-2727
Practice Address - Country:US
Practice Address - Phone:513-218-2848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRI STATE URGENT CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-30
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response AttendantGroup - Single Specialty