Provider Demographics
NPI:1902842487
Name:QUICKCLINIC, LLC
Entity Type:Organization
Organization Name:QUICKCLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:V
Authorized Official - Last Name:BUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-665-0010
Mailing Address - Street 1:3009 SMITH RD
Mailing Address - Street 2:350
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-2666
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4445 KENT RD
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-4332
Practice Address - Country:US
Practice Address - Phone:330-678-3500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHQU9351893Medicare ID - Type Unspecified
OHY27722Medicare UPIN