Provider Demographics
NPI:1508633637
Name:MEDIFAST URGENT CARE LLC
Entity Type:Organization
Organization Name:MEDIFAST URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:JEANNE
Authorized Official - Last Name:KRANZ
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:402-317-1008
Mailing Address - Street 1:3830 N 167TH CT
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68116-8064
Mailing Address - Country:US
Mailing Address - Phone:402-965-4000
Mailing Address - Fax:402-965-4001
Practice Address - Street 1:3830 N 167TH CT
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68116-8064
Practice Address - Country:US
Practice Address - Phone:402-965-4000
Practice Address - Fax:402-965-4001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-08
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care