Healthcare Provider Details

I. General information

NPI: 1104280346
Provider Name (Legal Business Name): URGENT CARE AT HOME, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2016
Last Update Date: 04/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 INNOVATION WAY STE. 400
NEWARK DE
19711
US

IV. Provider business mailing address

56 W. MAIN STREET STE. 305
CHRISTIANA DE
19702
US

V. Phone/Fax

Practice location:
  • Phone: 302-273-2247
  • Fax: 302-533-6818
Mailing address:
  • Phone: 302-273-2247
  • Fax: 302-533-6818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. EDWARD CARPENTER WHITE JR.
Title or Position: PRESIDENT
Credential:
Phone: 302-283-9001