1255613329 NPI number — INSPIRA HEALTH NETWORK URGENT CARE, P.C.

Table of content: (NPI 1255613329)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255613329 NPI number — INSPIRA HEALTH NETWORK URGENT CARE, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INSPIRA HEALTH NETWORK URGENT CARE, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255613329
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/13/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2848 S DELSEA DR
Provider Second Line Business Mailing Address:
SUITE 4B
Provider Business Mailing Address City Name:
VINELAND
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08360-7042
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-205-7069
Provider Business Mailing Address Fax Number:
856-575-4938

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
201 TOMLIN STATION ROAD
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
MULLICA HILL
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08062
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-423-8666
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/15/2011

Additional Information

Authorized Official

Authorized Official Last Name:
LINN
Authorized Official First Name:
STEVEN
Authorized Official Middle Name:
C
Authorized Official Title or Position:
VICE PRESIDENT MEDICAL AFFAIRS
Authorized Official Telephone Number:
856-641-7515

Provider Taxonomy Codes

  • Taxonomy code: 261QU0200X , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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