# ROLLA URGENT CARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326099417
- **Authorized official:** MR. OLUYOMI OLUSANYA MD (OWNER/DEL OFFICIAL)
- **Authorized official phone:** (573) 426-5900

## Contact information

- **Practice address:** 1060 S BISHOP AVE, ROLLA, MO 65401-4411
- **Practice address phone:** (573) 426-5900
- **Practice address fax:** (573) 426-4466
- **Mailing address:** PO BOX 817, CAPE GIRARDEAU, MO 63702-0817
- **Mailing address phone:** (314) 989-0300

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 2002009086 | MO | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |
| 363LF0000X | Family Nurse Practitioner | 124268 | MO | — |

## Other

- **Enumeration date:** 05/13/2006
- **Last updated:** 09/14/2017