Provider Demographics
NPI:1255613329
Name:INSPIRA HEALTH NETWORK URGENT CARE, P.C.
Entity type:Organization
Organization Name:INSPIRA HEALTH NETWORK URGENT CARE, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT MEDICAL AFFAIRS
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:LINN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-641-7515
Mailing Address - Street 1:2848 S DELSEA DR
Mailing Address - Street 2:SUITE 4B
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-7042
Mailing Address - Country:US
Mailing Address - Phone:856-205-7069
Mailing Address - Fax:856-575-4938
Practice Address - Street 1:201 TOMLIN STATION ROAD
Practice Address - Street 2:SUITE B
Practice Address - City:MULLICA HILL
Practice Address - State:NJ
Practice Address - Zip Code:08062
Practice Address - Country:US
Practice Address - Phone:856-423-8666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-15
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ230668Medicare Oscar/Certification