Provider Demographics
NPI:1295976876
Name:PREMIER IMMEDIATE MEDICAL CARE, LLC PREMIER URGENT CARE
Entity type:Organization
Organization Name:PREMIER IMMEDIATE MEDICAL CARE, LLC PREMIER URGENT CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:SILVERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:610-728-6074
Mailing Address - Street 1:450 CRESSON BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:OAKS
Mailing Address - State:PA
Mailing Address - Zip Code:19456-0876
Mailing Address - Country:US
Mailing Address - Phone:610-728-6074
Mailing Address - Fax:610-728-6071
Practice Address - Street 1:1601 KINGS HWY N
Practice Address - Street 2:SUITE 800
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2309
Practice Address - Country:US
Practice Address - Phone:856-433-6200
Practice Address - Fax:856-433-6201
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PREMIER IMMEDIATE MEDICAL CARE,LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-03-12
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207P00000X
NJ0600337227261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ180052Medicare PIN