Provider Demographics
NPI:1205232014
Name:INSPIRA HEALTH NETWORK URGENT CARE PC
Entity type:Organization
Organization Name:INSPIRA HEALTH NETWORK URGENT CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RAGEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-205-7070
Mailing Address - Street 1:2848 S DELSEA DR
Mailing Address - Street 2:SUITE 4B
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-7042
Mailing Address - Country:US
Mailing Address - Phone:856-205-7070
Mailing Address - Fax:
Practice Address - Street 1:1038 E CHESTNUT AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-5800
Practice Address - Country:US
Practice Address - Phone:856-205-7070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-06
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
230668Medicare PIN