Provider Demographics
NPI:1356634216
Name:COMPREHENSIVE URGENT CARE LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:EMIL
Authorized Official - Middle Name:
Authorized Official - Last Name:KIROVSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-737-9999
Mailing Address - Street 1:4182 TONYA TRL
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-8549
Mailing Address - Country:US
Mailing Address - Phone:513-737-9999
Mailing Address - Fax:513-887-0123
Practice Address - Street 1:4182 TONYA TRL
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-8549
Practice Address - Country:US
Practice Address - Phone:513-737-9999
Practice Address - Fax:513-887-0123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-25
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35074249261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0050579Medicaid
OH617922400OtherUS DEPT OF LABOR
OH0050579Medicaid
OHDT3264Medicare PIN