Provider Demographics
NPI:1407216898
Name:EPIC URGENT CARE LLC
Entity Type:Organization
Organization Name:EPIC URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:EBENEZER
Authorized Official - Middle Name:
Authorized Official - Last Name:ALUMA
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:614-726-0025
Mailing Address - Street 1:1336 EAST MAIN STREET SUITE G
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-2062
Mailing Address - Country:US
Mailing Address - Phone:614-726-0025
Mailing Address - Fax:937-717-6689
Practice Address - Street 1:1336 EAST MAIN STREET SUITE G
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-2062
Practice Address - Country:US
Practice Address - Phone:614-726-0025
Practice Address - Fax:937-717-6689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-29
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50004245261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1649668427OtherNPI NUMBER