Provider Demographics
NPI:1811623713
Name:WARREN MEDICLINIC ASSOCIATES LTD LLP
Entity Type:Organization
Organization Name:WARREN MEDICLINIC ASSOCIATES LTD LLP
Other - Org Name:MEDICLINIC URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LEAD ADVANCED PRACTICE PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:DOMENIC
Authorized Official - Middle Name:A
Authorized Official - Last Name:BERMUDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:513-844-1111
Mailing Address - Street 1:7921 JESSIES WAY
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-8077
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7921 JESSIES WAY
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-8077
Practice Address - Country:US
Practice Address - Phone:513-844-1111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-25
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty