Provider Demographics
NPI:1720589351
Name:CLASSEN URGENT CARE CLINIC LLC
Entity Type:Organization
Organization Name:CLASSEN URGENT CARE CLINIC LLC
Other - Org Name:CLASSEN URGENT CARE - MOORE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:HUSSEIN
Authorized Official - Middle Name:
Authorized Official - Last Name:TORBATI
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:405-701-7111
Mailing Address - Street 1:2818 CLASSEN BLVD
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-4059
Mailing Address - Country:US
Mailing Address - Phone:405-701-7111
Mailing Address - Fax:405-701-7165
Practice Address - Street 1:1025 SW 4TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-2404
Practice Address - Country:US
Practice Address - Phone:405-701-7111
Practice Address - Fax:405-445-7660
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLASSEN URGENT CARE CLINIC LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-02-28
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK261QU0200X261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center