Provider Demographics
NPI:1992359830
Name:FRENCHTOWN URGENT CARE, PLLC
Entity type:Organization
Organization Name:FRENCHTOWN URGENT CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:R
Authorized Official - Last Name:PESHL
Authorized Official - Suffix:
Authorized Official - Credentials:MHSA, MBA
Authorized Official - Phone:734-244-4110
Mailing Address - Street 1:3751 N DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48162-4489
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3751 N DIXIE HWY
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-4489
Practice Address - Country:US
Practice Address - Phone:734-244-4110
Practice Address - Fax:734-244-4900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-29
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No291U00000XLaboratoriesClinical Medical Laboratory
No332900000XSuppliersNon-Pharmacy Dispensing Site