Provider Demographics
NPI:1912177908
Name:THE URGENT CARE GROUP, PA
Entity Type:Organization
Organization Name:THE URGENT CARE GROUP, PA
Other - Org Name:OCCUPATIONAL MEDICINE SOUTH, PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:KULIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:609-549-8344
Mailing Address - Street 1:1395 ROUTE 539 STE 2
Mailing Address - Street 2:
Mailing Address - City:LITTLE EGG HARBOR TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08087-9770
Mailing Address - Country:US
Mailing Address - Phone:609-549-8344
Mailing Address - Fax:609-879-5484
Practice Address - Street 1:2605 SHORE RD UNIT C
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-2136
Practice Address - Country:US
Practice Address - Phone:609-365-5333
Practice Address - Fax:609-365-5336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-05
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1912177908OtherHORIZON