Provider Demographics
NPI:1851915680
Name:NEVADA URGENT CARE NETWORK LLC
Entity Type:Organization
Organization Name:NEVADA URGENT CARE NETWORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP - PHYS OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-382-4943
Mailing Address - Street 1:367 S GULPH RD
Mailing Address - Street 2:ATTN IPM CREDENTIALING
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-3121
Mailing Address - Country:US
Mailing Address - Phone:610-382-4943
Mailing Address - Fax:610-878-3965
Practice Address - Street 1:5265 VISTA BLVD BLDG B
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89436-0836
Practice Address - Country:US
Practice Address - Phone:610-382-4943
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-08
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care