Provider Demographics
NPI:1831104660
Name:REYNOLDSBURG ADULT URGENT CARE
Entity Type:Organization
Organization Name:REYNOLDSBURG ADULT URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GIRRAL
Authorized Official - Middle Name:K
Authorized Official - Last Name:BANSAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-864-9380
Mailing Address - Street 1:1649 BRICE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-2758
Mailing Address - Country:US
Mailing Address - Phone:614-864-9380
Mailing Address - Fax:614-864-8811
Practice Address - Street 1:1649 BRICE RD
Practice Address - Street 2:SUITE B
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-2758
Practice Address - Country:US
Practice Address - Phone:614-864-9380
Practice Address - Fax:614-864-8811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHGI9358781Medicare ID - Type UnspecifiedMEDICARE