Provider Demographics
NPI:1598791980
Name:TRI STATE URGENT CARE LLC
Entity Type:Organization
Organization Name:TRI STATE URGENT CARE LLC
Other - Org Name:COLD SPRING URGENT CARE-OAKLEY URGENT CARE-TRE STATE MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MAJID
Authorized Official - Middle Name:A
Authorized Official - Last Name:QURESHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-531-1555
Mailing Address - Street 1:PO BOX 76009
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND HEIGHTS
Mailing Address - State:KY
Mailing Address - Zip Code:41076-0009
Mailing Address - Country:US
Mailing Address - Phone:513-531-1555
Mailing Address - Fax:513-531-2068
Practice Address - Street 1:5002 RIDGE AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45209-5015
Practice Address - Country:US
Practice Address - Phone:513-531-1555
Practice Address - Fax:513-531-2068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02-1392750207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2572130Medicaid
OH9354381Medicare PIN