Provider Demographics
NPI:1285185587
Name:ZIPCLINIC URGENT CARE
Entity Type:Organization
Organization Name:ZIPCLINIC URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. CONTRACTING & CREDENTIALING SPE
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:KNORR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-789-6695
Mailing Address - Street 1:2508 SCOTTSVILLE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-4400
Mailing Address - Country:US
Mailing Address - Phone:270-746-6330
Mailing Address - Fax:
Practice Address - Street 1:2508 SCOTTSVILLE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-4400
Practice Address - Country:US
Practice Address - Phone:270-746-6330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-21
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QP2300X, 261QU0200X
KY3010757305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No305S00000XManaged Care OrganizationsPoint of Service