Medexpress Urgent Care - New Jersey, Inc.

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

MEDEXPRESS URGENT CARE - NEW JERSEY, INC.

Doing business as

MedExpress Urgent Care - Runnemede

Practice address

165 S Black Horse Pike
Runnemede, NJ 08078-1906

Phone

(856) 939-1658

Fax

(856) 939-1647

NPI assigned

Apr 11, 2013

Last updated

Sep 8, 2016By 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

Mr. Tim G Bugin

Title

VP of Payor Contracting

Phone

(304) 225-2500

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• MedExpress Urgent Care - Runnemede Doing business as

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

{
    "created_epoch": "1365638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473292800000",
    "number": "1992148746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 CONSOL ENERGY DR",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153176506",
            "telephone_number": "304-225-2500",
            "fax_number": "724-743-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 S BLACK HORSE PIKE",
            "city": "RUNNEMEDE",
            "state": "NJ",
            "postal_code": "080781906",
            "telephone_number": "856-939-1658",
            "fax_number": "856-939-1647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDEXPRESS URGENT CARE - NEW JERSEY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-11",
        "last_updated": "2016-09-08",
        "status": "A",
        "authorized_official_last_name": "BUGIN",
        "authorized_official_first_name": "TIM",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "VP OF PAYOR CONTRACTING",
        "authorized_official_telephone_number": "304-225-2500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0347116",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedExpress Urgent Care - Runnemede",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ivan Rafael Lockward Jr., MD, MPH
• Nicholas Ma
• Esther Malave, MD
• Debra McMire, MSN FNPC
• Kyrie McNeill
• Zofia Mlynarz, MSW LCSW
• Ashley E Nelson
• New Jersey CVS Pharmacy LLC (CVS Pharmacy 00836)
• Pacilio Chiropractic Associates LLC
• Vincent J Pacilio, D.C.

• Urgent Care Clinic/Center in Runnemede, NJ
• Providers in Runnemede, NJ by specialty
• Urgent Care Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2016; 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.