Provider Demographics
NPI:1831126283
Name:VALLEY URGENT CARE P.C.
Entity Type:Organization
Organization Name:VALLEY URGENT CARE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:KEMERER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:989-791-3888
Mailing Address - Street 1:3061 CHRISTY WAY
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-2267
Mailing Address - Country:US
Mailing Address - Phone:989-791-2455
Mailing Address - Fax:989-791-1392
Practice Address - Street 1:3020 BOARDWALK DR
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-2324
Practice Address - Country:US
Practice Address - Phone:989-791-3888
Practice Address - Fax:989-791-3859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-28
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101010926207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4972286Medicaid
MI3040574Medicaid
MI4244855Medicaid
MI4943589Medicaid
MI0G36398Medicare PIN
MIF05009Medicare UPIN
MIE31609Medicare UPIN
MIQ72304Medicare UPIN
MI3040574Medicaid