Provider Demographics
NPI:1841636735
Name:OHP WALK-IN CLINICS LLC
Entity type:Organization
Organization Name:OHP WALK-IN CLINICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:FORTNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-781-6477
Mailing Address - Street 1:PO BOX 51328
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42102-5628
Mailing Address - Country:US
Mailing Address - Phone:270-781-6477
Mailing Address - Fax:270-647-6479
Practice Address - Street 1:5796 NASHVILLE RD
Practice Address - Street 2:STE A
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-7546
Practice Address - Country:US
Practice Address - Phone:270-781-6477
Practice Address - Fax:270-781-6479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-17
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY740244261QX0100X
261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine