Provider Demographics
NPI:1235588823
Name:FAMILY URGENT CARE LLC
Entity Type:Organization
Organization Name:FAMILY URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LESIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEDORIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-726-0025
Mailing Address - Street 1:879 N BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-1704
Mailing Address - Country:US
Mailing Address - Phone:740-772-5050
Mailing Address - Fax:740-772-5051
Practice Address - Street 1:1180 NORTH COURT STREET
Practice Address - Street 2:FAMILY URGENT CARE, LLC
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113
Practice Address - Country:US
Practice Address - Phone:740-772-5050
Practice Address - Fax:740-772-5051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-06
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35080597261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHG0088467Medicaid