Provider Demographics
NPI:1881991792
Name:MASON URGENT CARE LLC
Entity type:Organization
Organization Name:MASON URGENT CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BASHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIJAWI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-377-7860
Mailing Address - Street 1:1 N BROOKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013
Mailing Address - Country:US
Mailing Address - Phone:513-377-7860
Mailing Address - Fax:513-805-4498
Practice Address - Street 1:1 N BROOKWOOD AVE
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013
Practice Address - Country:US
Practice Address - Phone:513-377-7860
Practice Address - Fax:513-805-4498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-12
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-081770261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0059088Medicaid
OHH082860Medicare UPIN