Provider Demographics
NPI:1639205032
Name:AVON MEDICAL AND URGENT CARE CENTER,LLC
Entity Type:Organization
Organization Name:AVON MEDICAL AND URGENT CARE CENTER,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHUKA
Authorized Official - Middle Name:
Authorized Official - Last Name:ONYENEKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-317-0769
Mailing Address - Street 1:2100 CENTER RD
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011-1891
Mailing Address - Country:US
Mailing Address - Phone:440-934-3538
Mailing Address - Fax:
Practice Address - Street 1:2100 CENTER RD
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:OH
Practice Address - Zip Code:44011-1891
Practice Address - Country:US
Practice Address - Phone:440-934-3538
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH65855261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care