Provider Demographics
NPI:1548442544
Name:FAMILY AND URGENT CARE, LLC
Entity type:Organization
Organization Name:FAMILY AND URGENT CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DELORIS
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:KRUG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-362-2215
Mailing Address - Street 1:501 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:CRAWFORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47933-1337
Mailing Address - Country:US
Mailing Address - Phone:765-362-2215
Mailing Address - Fax:765-361-9642
Practice Address - Street 1:501 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:CRAWFORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47933-1337
Practice Address - Country:US
Practice Address - Phone:765-362-2215
Practice Address - Fax:765-361-9642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-30
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN254650Medicare PIN