Provider Demographics
NPI:1316224496
Name:REGIONAL URGENT CARE OF MAYS LANDING
Entity Type:Organization
Organization Name:REGIONAL URGENT CARE OF MAYS LANDING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:SOUCIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-909-0200
Mailing Address - Street 1:5401 HARDING HYWAY
Mailing Address - Street 2:SUITE #5
Mailing Address - City:MAYS LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:08330
Mailing Address - Country:US
Mailing Address - Phone:609-909-0200
Mailing Address - Fax:609-909-0267
Practice Address - Street 1:5401 HARDING HWY
Practice Address - Street 2:SUITE #5
Practice Address - City:MAYS LANDING
Practice Address - State:NJ
Practice Address - Zip Code:08330-2243
Practice Address - Country:US
Practice Address - Phone:609-909-0200
Practice Address - Fax:609-909-0267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-03
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB44301261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care