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.

Doing business as

CareSTAT Urgent Care Centers

Practice address

1305 W Chester Pike
Havertown, PA 19083-2929

Phone

(410) 420-6970

NPI assigned

Jun 16, 2011

Last updated

May 4, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Maurice Reid, MDNPI 1679573687

Title

Ceo

Phone

(410) 569-0044

Specialties & licenses 1

Addresses

Other names 1

• CareSTAT Urgent Care Centers Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Maurice N Reid, M.D.

  • Specialist
  • Bel Air, MD
  • NPI 1679573687
  Authorized official Same address or phone

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": [],
    "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.