Provider Demographics
NPI:1548586340
Name:GEORGE MANJA LLC
Entity Type:Organization
Organization Name:GEORGE MANJA LLC
Other - Org Name:NORTHSTAR URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:MANJA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-365-2300
Mailing Address - Street 1:2733 BUTTERMILK RD
Mailing Address - Street 2:
Mailing Address - City:HELLERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18055-3358
Mailing Address - Country:US
Mailing Address - Phone:610-365-2300
Mailing Address - Fax:610-365-8363
Practice Address - Street 1:430 NAZARETH PIKE
Practice Address - Street 2:
Practice Address - City:NAZARETH
Practice Address - State:PA
Practice Address - Zip Code:18064
Practice Address - Country:US
Practice Address - Phone:610-365-2300
Practice Address - Fax:610-365-8363
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GEORGE MANJA LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-04-19
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD058653-L261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care