Provider Demographics
NPI:1609187905
Name:ADVANCED URGENT CARE PC
Entity Type:Organization
Organization Name:ADVANCED URGENT CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:VULLINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-927-5921
Mailing Address - Street 1:PO BOX 957
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18501-0957
Mailing Address - Country:US
Mailing Address - Phone:814-308-8155
Mailing Address - Fax:814-308-8584
Practice Address - Street 1:2615 E COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-7512
Practice Address - Country:US
Practice Address - Phone:814-308-8155
Practice Address - Fax:814-308-8584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-01
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty