Healthcare Provider Details

I. General information

NPI: 1770301822
Provider Name (Legal Business Name): IRMC URGICARE AT INDIANA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2024
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2128 OAKLAND AVE
INDIANA PA
15701-3384
US

IV. Provider business mailing address

640 KOLTER DR
INDIANA PA
15701-3570
US

V. Phone/Fax

Practice location:
  • Phone: 724-349-4362
  • Fax:
Mailing address:
  • Phone: 724-357-7196
  • Fax: 724-357-7279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: APRIL MILLER
Title or Position: EXEC DIRECTOR OF REV CYCLE ACCTG
Credential:
Phone: 724-357-7009