Provider Demographics
NPI:1043378151
Name:ORANGE URGENT CARE PLLC
Entity Type:Organization
Organization Name:ORANGE URGENT CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:R
Authorized Official - Last Name:RUVO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-565-3700
Mailing Address - Street 1:75 CRYSTAL RUN RD
Mailing Address - Street 2:SUITE G40
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10941-7000
Mailing Address - Country:US
Mailing Address - Phone:845-703-2273
Mailing Address - Fax:845-703-2276
Practice Address - Street 1:75 CRYSTAL RUN RD
Practice Address - Street 2:SUITE G40
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10941-7000
Practice Address - Country:US
Practice Address - Phone:845-703-2273
Practice Address - Fax:845-703-2276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05001134Medicaid