# MEDIFAST URGENT CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MEDIFAST URGENT CARE LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1124963434
- **Legal business name:** MEDIFAST URGENT CARE LLC
- **Authorized official:** JON ROBERT WILSON (OWNER)
- **Authorized official phone:** (402) 965-4000

## Contact information

- **Practice address:** 3830 N 167TH CT, OMAHA, NE 68116-8064
- **Practice address phone:** (402) 965-4000
- **Practice address fax:** (402) 965-4001
- **Mailing address:** 3830 N 167TH CT, OMAHA, NE 68116-8064
- **Mailing address phone:** (402) 965-4000
- **Mailing address fax:** (402) 965-4001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/22/2026
- **Last updated:** 04/22/2026