Provider Demographics
NPI:1326097502
Name:COMMUNITY URGENT CARE INC.
Entity Type:Organization
Organization Name:COMMUNITY URGENT CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:A
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-327-0552
Mailing Address - Street 1:2555 CREEKWOOD CT
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45504-4056
Mailing Address - Country:US
Mailing Address - Phone:937-327-0552
Mailing Address - Fax:937-327-0556
Practice Address - Street 1:2555 CREEKWOOD CT
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-4056
Practice Address - Country:US
Practice Address - Phone:937-327-0552
Practice Address - Fax:937-327-0556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2162832Medicaid
OH2162832Medicaid