Healthcare Provider Details

I. General information

NPI: 1982209201
Provider Name (Legal Business Name): URGENT CARE ON CALL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2020
Last Update Date: 01/15/2021
Certification Date: 01/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 W 7TH ST
PLAINFIELD NJ
07060-1511
US

IV. Provider business mailing address

315 W 7TH ST
PLAINFIELD NJ
07060-1511
US

V. Phone/Fax

Practice location:
  • Phone: 732-770-2904
  • Fax:
Mailing address:
  • Phone: 732-770-2904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: SAMPSON M DAVIS
Title or Position: AUTHORIZED MEMBER
Credential: MD
Phone: 732-770-2904