North Coast Professional Company, LLC

Organization Active NPI Urgent Care Clinic/Center · Clyde, OH

NPI 1992136279 · NPPES record last updated Dec 20, 2013

Key facts

NPI
1992136279
Entity type
Organization (NPI type 2)
Primary specialty
Urgent Care Clinic/Center 261QU0200X
Legal business name
NORTH COAST PROFESSIONAL COMPANY, LLC
Practice address
1470 West McPherson Highway
Clyde, OH 43410
Phone
(419) 557-5541
Fax
(419) 557-5542
NPI assigned
Dec 11, 2013
Organization subpart
No

Authorized official

Name
Janis A Shriver, HCMBA, CPA
Title
Vice President
Phone
(419) 557-5540

Corporate family (same tax ID) 3

Organizations that report the same tax identification number in the National Provider Directory.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2072137Firelands Physicians Group - Urgent
1470 W McPherson Hwy, Clyde, OH 43410
Certificate of waiverJan 26, 2028

National Provider Directory

Tax ID family
Firelands Physician Group Urgent Care (4 organizations share this tax ID)

Locations

1470 W McPherson Hwy
Clyde, OH 43410
Phone (419) 547-0700

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Yes

Addresses

Primary practice location

1470 West McPherson Highway
Clyde, OH 43410

Mailing address

1031 Pierce St
Suite D
Sandusky, OH 44870-4669
Phone (419) 557-5541

Other identifiers

IdentifierTypeStateIssuer
2021707MedicaidOH

Other names

  • Firelands Physician Group Urgent Care Doing business as

Other providers in Clyde, OH

All providers in Clyde, OH · Urgent Care Clinic/Center in Ohio

Sources for this page

Verify at the official NPI Registry.