Provider Demographics
NPI:1891061453
Name:DIXIE URGENT CARE INC,
Entity Type:Organization
Organization Name:DIXIE URGENT CARE INC,
Other - Org Name:URGENT CARE OF LOVELAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:THORAYA
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:513-218-2848
Mailing Address - Street 1:10582 LOVELAND MADEIRA RD
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-8962
Mailing Address - Country:US
Mailing Address - Phone:513-677-2400
Mailing Address - Fax:513-531-2068
Practice Address - Street 1:10582 LOVELAND MADEIRA RD
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-8962
Practice Address - Country:US
Practice Address - Phone:513-531-1505
Practice Address - Fax:513-531-2068
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DIXIE URGENT CARE INC,
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-03-28
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCL021992000146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response AttendantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2988414Medicaid
OH2988414Medicaid