Provider Demographics
NPI:1205175387
Name:DAYTON PRIMARY & URGENT CARE
Entity type:Organization
Organization Name:DAYTON PRIMARY & URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:VERON
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:937-461-8933
Mailing Address - Street 1:301 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45402-3033
Mailing Address - Country:US
Mailing Address - Phone:937-461-0800
Mailing Address - Fax:937-461-8930
Practice Address - Street 1:301 W 1ST ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-3033
Practice Address - Country:US
Practice Address - Phone:937-461-0800
Practice Address - Fax:937-461-8930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-08
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35038418261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care