Provider Demographics
NPI:1740377274
Name:DELMARVA URGI-CARE CENTERS, LLC
Entity type:Organization
Organization Name:DELMARVA URGI-CARE CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KENT
Authorized Official - Middle Name:M
Authorized Official - Last Name:RILLING
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:410-543-2020
Mailing Address - Street 1:PO BOX 1936
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21802-1936
Mailing Address - Country:US
Mailing Address - Phone:410-543-2020
Mailing Address - Fax:
Practice Address - Street 1:659 S SALISBURY BLVD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-5431
Practice Address - Country:US
Practice Address - Phone:410-543-2020
Practice Address - Fax:410-352-3024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0002135146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD=========OtherTAX ID#