Provider Demographics
NPI:1073080966
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:TOWER HEALTH URGENT CARE, LLC
Mailing Address - Street 2:10050 ROOSEVELT BLVD SUITE 2
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19116-3956
Mailing Address - Country:US
Mailing Address - Phone:215-552-2818
Mailing Address - Fax:484-713-5255
Practice Address - Street 1:1745 S. EASTON ROAD
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2812
Practice Address - Country:US
Practice Address - Phone:267-880-4200
Practice Address - Fax:267-880-4201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-29
Last Update Date:2019-02-21
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
PA103575918-0003Medicaid
PA4171047OtherHIGHMARK BCBS