Healthcare Provider Details

I. General information

NPI: 1982946257
Provider Name (Legal Business Name): HCE NORTHEAST LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2013
Last Update Date: 03/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4065 QUAKERBRIDGE RD
PRINCETON JCT NJ
08550-5243
US

IV. Provider business mailing address

3515 RICHMOND RD
TEXARKANA TX
75503-0711
US

V. Phone/Fax

Practice location:
  • Phone: 609-297-0546
  • Fax:
Mailing address:
  • Phone: 903-791-9355
  • Fax: 903-831-7259

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: HAL PATTON
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 903-791-9355