Provider Demographics
NPI:1518283753
Name:EPN HAMOT URGENT CARE LLC
Entity Type:Organization
Organization Name:EPN HAMOT URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:M
Authorized Official - Last Name:CACCHIONE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:814-454-3363
Mailing Address - Street 1:3535 PINE AVE
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16504-1743
Mailing Address - Country:US
Mailing Address - Phone:814-456-5469
Mailing Address - Fax:814-453-2698
Practice Address - Street 1:7200 PEACH ST
Practice Address - Street 2:UNIT 420
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-4754
Practice Address - Country:US
Practice Address - Phone:814-860-3301
Practice Address - Fax:814-860-3302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-13
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Multi-Specialty