Provider Demographics
NPI:1952708000
Name:WEST TOLEDO URGENT CARE LLC
Entity type:Organization
Organization Name:WEST TOLEDO URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ABDUL
Authorized Official - Middle Name:
Authorized Official - Last Name:QUAZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-517-0146
Mailing Address - Street 1:2627 TREMAINSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43613-2509
Mailing Address - Country:US
Mailing Address - Phone:419-794-1006
Mailing Address - Fax:
Practice Address - Street 1:2627 TREMAINSVILLE RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43613-2509
Practice Address - Country:US
Practice Address - Phone:419-794-1006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-04
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0115706Medicaid
OH0115706Medicaid