Main Line Urgent Care Medical Group, P.C.

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

MAIN LINE URGENT CARE MEDICAL GROUP, P.C.

Practice address

1305 W Chester Pike
Havertown, PA 19083-2929

Phone

(410) 420-6970

NPI assigned

Jun 16, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Maurice Reid, MD

Title

Ceo

Phone

(410) 569-0044

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• CareSTAT Urgent Care Centers Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1308182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525392000000",
    "number": "1477848422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 E CHURCHVILLE RD",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144742",
            "telephone_number": "410-420-6970",
            "fax_number": "410-420-6967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 W CHESTER PIKE",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190832929",
            "telephone_number": "410-420-6970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN LINE URGENT CARE MEDICAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-16",
        "last_updated": "2018-05-04",
        "status": "A",
        "authorized_official_last_name": "REID",
        "authorized_official_first_name": "MAURICE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-569-0044",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI REGISTRY",
            "identifier": "1891792255",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CareSTAT Urgent Care Centers",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CareSTAT Urgent Care Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pawel Czeslaw Machura
• Joseph Mack
• David M Maconi, DDS
• Thomas J Maddaloni, CRNA
• Ronald Madison
• Selena Majeed
• Erin Maloney, MA
• Lisa R. Mandell, IBCLC
• Mark F Mangano, MD
• Nicholas Philip Mangano III

• Urgent Care Clinic/Center in Havertown, PA
• Providers in Havertown, PA by specialty
• Urgent Care Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.