Premier Urgent Care at Kennett Square, LLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

PREMIER URGENT CARE AT KENNETT SQUARE, LLC

Practice address

10050 Roosevelt Blvd Ste 2
Philadelphia, PA 19116-3965

Phone

(215) 552-2818

Fax

(484) 713-5255

NPI assigned

Jan 23, 2018

Organization subpart

No

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

Authorized official

Name

Laura O'Gorman

Title

Credentialing Manager

Phone

(215) 552-2818

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Premier Urgent Care at Kennett Square LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Premier Urgent Care at Kennett Square, LLC

  • Urgent Care Clinic/Center
  • Philadelphia, PA
  • NPI 1679084354
  NPD tax ID
• Premier Urgent Care Plymouth Meeting, LLC

  • Urgent Care Clinic/Center
  • Plymouth Meeting, PA
  • NPI 1235561572
  NPD tax ID

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

{
    "created_epoch": "1516665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1538667704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10050 ROOSEVELT BLVD STE 2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191163965",
            "telephone_number": "215-552-2818",
            "fax_number": "484-713-5255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10050 ROOSEVELT BLVD STE 2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191163965",
            "telephone_number": "215-552-2818",
            "fax_number": "484-713-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER URGENT CARE AT KENNETT SQUARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-23",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "O'GORMAN",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "215-552-2818"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1027657760001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Premier Pain & Rehab Center
• Premier Pediatrics, LLC
• Premier Physical Therapy & Wellness
• Premier Physical Therapy, P.C.
• Premier Respiratory Soulutions LLC
• Premier Urgent Care at Kennett Square, LLC
• Premiere Dental of Philadelphia
• Premiervision Laser Center, Inc.
• Tamar J Preminger, MD
• Premise Health of Pennsylvania Medical PC

• Urgent Care Clinic/Center in Philadelphia, PA
• Providers in Philadelphia, 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 Jun 16, 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.