Provider Demographics
NPI:1427374230
Name:OUR URGENT CARE, LLC
Entity Type:Organization
Organization Name:OUR URGENT CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUDHEER
Authorized Official - Middle Name:C
Authorized Official - Last Name:ATLURI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:636-887-3020
Mailing Address - Street 1:P O BOX 795216
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63179-0795
Mailing Address - Country:US
Mailing Address - Phone:636-887-3020
Mailing Address - Fax:636-887-3022
Practice Address - Street 1:1343 NORTH EAST SERVICE RD
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:MO
Practice Address - Zip Code:63383
Practice Address - Country:US
Practice Address - Phone:636-377-2100
Practice Address - Fax:636-887-3022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-19
Last Update Date:2010-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO100503261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO501015002Medicaid
MO501015002Medicaid
MO000015439Medicare PIN