Provider Demographics
NPI:1740627926
Name:CARE1 URGENT CARE LLC
Entity type:Organization
Organization Name:CARE1 URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:WARD
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:570-484-9143
Mailing Address - Street 1:266 HOGAN BLVD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:MILL HALL
Mailing Address - State:PA
Mailing Address - Zip Code:17751-1928
Mailing Address - Country:US
Mailing Address - Phone:570-484-9143
Mailing Address - Fax:570-484-9193
Practice Address - Street 1:266 HOGAN BLVD
Practice Address - Street 2:SUITE 4
Practice Address - City:MILL HALL
Practice Address - State:PA
Practice Address - Zip Code:17751-1928
Practice Address - Country:US
Practice Address - Phone:570-484-9143
Practice Address - Fax:570-484-9193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-29
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QU0200X261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care