Provider Demographics
NPI:1538380332
Name:CENTRAL OHIO URGENT CARE
Entity type:Organization
Organization Name:CENTRAL OHIO URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IKENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:NZEOGU
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:614-436-6009
Mailing Address - Street 1:5801 TAMARACK BLVD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-3747
Mailing Address - Country:US
Mailing Address - Phone:614-436-6009
Mailing Address - Fax:614-436-6011
Practice Address - Street 1:5801 TAMARACK BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-3747
Practice Address - Country:US
Practice Address - Phone:614-436-6009
Practice Address - Fax:614-436-6011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2487616Medicaid
OH9343141OtherMEDICARE NUMBER
OH2487616Medicaid