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NPI Code Detail

MEDICARE: AGILE URGENT CARE LLC

MEDICARE: AGILE URGENT CARE LLC
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
1207RC0000XCardiovascular Disease Physician
2261QR0200XRadiology Clinic/Center
3261QR0401XComprehensive Outpatient Rehabilitation Facility (CORF)
4261QS1200XSleep Disorder Diagnostic Clinic/Center
5261QU0200XUrgent Care Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
125055OTHERNJPRIMARY CARE AMBULATORY CARE LICENSE

General Provider Information

NPI Number : 1578264453
Entity Type Code : Organization
Provider Name (Legal Business Name) : AGILE URGENT CARE LLC
Provider Business Mailing Address
First Line : 20 MEADOWLANDS PKWY
Second Line :
City : SECAUCUS
State : NJ
Zip : 07094-2944
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 20 MEADOWLANDS PKWY
Second Line :
City : SECAUCUS
State : NJ
Zip : 07094-2944
Country : US
Telephone Number : 201-381-4800
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : HETAL RAO
Credential :
Telephone Number : 201-289-1790
Provider Enumeration Date : 03/16/2023
Last Update Date : 02/06/2024

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Directions to “AGILE URGENT CARE LLC ” Practice Location

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