Provider Demographics
NPI:1891250643
Name:FAMILY URGENT CARE LLC
Entity Type:Organization
Organization Name:FAMILY URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LESIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEDORIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-450-1244
Mailing Address - Street 1:879 N BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-1704
Mailing Address - Country:US
Mailing Address - Phone:740-772-5050
Mailing Address - Fax:
Practice Address - Street 1:1860 SOUTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:BELLEFONTAINE
Practice Address - State:OH
Practice Address - Zip Code:43311-9997
Practice Address - Country:US
Practice Address - Phone:937-592-0731
Practice Address - Fax:937-592-0727
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY URGENT CARE LLC/ FAMILY PRACTICE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-06
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty