Provider Demographics
NPI:1932351186
Name:ALPHA CHOICE URGENT CARE AND OCCUPATIONAL HEALTH LLC
Entity Type:Organization
Organization Name:ALPHA CHOICE URGENT CARE AND OCCUPATIONAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BABATUNDE
Authorized Official - Middle Name:T
Authorized Official - Last Name:ONAMUSI
Authorized Official - Suffix:
Authorized Official - Credentials:MD MPH CIME
Authorized Official - Phone:937-938-8557
Mailing Address - Street 1:255 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4617
Mailing Address - Country:US
Mailing Address - Phone:937-938-8557
Mailing Address - Fax:937-938-6684
Practice Address - Street 1:255 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-4617
Practice Address - Country:US
Practice Address - Phone:937-938-8557
Practice Address - Fax:937-938-6684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-080079261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
1346305539OtherINDIVIDUAL PROVIDER NPI
OHH76480Medicare UPIN