Provider Demographics
NPI:1003383993
Name:TOWER HEALTH URGENT CARE, LLC
Entity Type:Organization
Organization Name:TOWER HEALTH URGENT CARE, LLC
Other - Org Name:TOWER HEALTH URGENT CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:VP AND CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:CONNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-628-8790
Mailing Address - Street 1:PO BOX 13579
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19612-3579
Mailing Address - Country:US
Mailing Address - Phone:484-628-1324
Mailing Address - Fax:484-334-7026
Practice Address - Street 1:300 OLD FORGE LN STE 302
Practice Address - Street 2:
Practice Address - City:KENNETT SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348-1897
Practice Address - Country:US
Practice Address - Phone:484-778-8000
Practice Address - Fax:484-788-8001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-29
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4171047OtherHIGHMARK BCBS
PA103575918-0006Medicaid