Healthcare Provider Details

I. General information

NPI: 1417402249
Provider Name (Legal Business Name): EXPRESS URGENT CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2016
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

449 SCRANTON CARBONDALE HWY
DICKSON CITY PA
18508
US

IV. Provider business mailing address

449 SCRANTON CARBONDALE HWY
SCRANTON PA
18508-1115
US

V. Phone/Fax

Practice location:
  • Phone: 570-344-6000
  • Fax: 570-344-6002
Mailing address:
  • Phone: 570-344-6000
  • Fax: 570-344-6002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHAHROON RIAZ CHOUDHRY
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 570-344-6000