Provider Demographics
NPI:1295181022
Name:MAKE MEDICAL, LLC
Entity Type:Organization
Organization Name:MAKE MEDICAL, LLC
Other - Org Name:URGENT CARE NETWORK CROSSROADS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:R
Authorized Official - Last Name:MERTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-933-8201
Mailing Address - Street 1:325 N 72ND ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3605
Mailing Address - Country:US
Mailing Address - Phone:402-715-5272
Mailing Address - Fax:402-763-8816
Practice Address - Street 1:325 N 72ND ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-3605
Practice Address - Country:US
Practice Address - Phone:402-715-5272
Practice Address - Fax:402-763-8816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-11
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care