Provider Demographics
NPI:1861971384
Name:MEDCARE URGENT CARE PLLC
Entity type:Organization
Organization Name:MEDCARE URGENT CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:RONI
Authorized Official - Middle Name:
Authorized Official - Last Name:AUOB
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:313-300-2549
Mailing Address - Street 1:26611 W 7 MILE RD
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48240-2063
Mailing Address - Country:US
Mailing Address - Phone:313-300-2549
Mailing Address - Fax:
Practice Address - Street 1:26611 W 7 MILE RD
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48240-2063
Practice Address - Country:US
Practice Address - Phone:313-300-6549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-07
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI166851028Medicaid