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NPI Code Detail

MEDICARE: PENNSYLVANIA URGENT CARE CENTERS

MEDICARE: PENNSYLVANIA URGENT CARE CENTERS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QU0200XUrgent Care Clinic/CenterMD435698PA

General Provider Information

NPI Number : 1386996452
Entity Type Code : Organization
Provider Name (Legal Business Name) : PENNSYLVANIA URGENT CARE CENTERS
Provider Business Mailing Address
First Line : 1444 W PASSYUNK AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19145-2312
Country : US
Telephone Number : 610-518-1060
Fax Number :
Provider Business Practice Location Address
First Line : 1444 W PASSYUNK AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19145-2312
Country : US
Telephone Number : 610-518-1060
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. MADHAVI V CHERUKURI
Credential : MD
Telephone Number : 610-518-1060
Provider Enumeration Date : 10/12/2012
Last Update Date : 10/12/2012

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Directions to “PENNSYLVANIA URGENT CARE CENTERS ” Practice Location

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