Provider Demographics
NPI:1104280346
Name:URGENT CARE AT HOME, LLC
Entity type:Organization
Organization Name:URGENT CARE AT HOME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:CARPENTER
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:302-283-9001
Mailing Address - Street 1:56 W. MAIN STREET
Mailing Address - Street 2:STE. 305
Mailing Address - City:CHRISTIANA
Mailing Address - State:DE
Mailing Address - Zip Code:19702
Mailing Address - Country:US
Mailing Address - Phone:302-273-2247
Mailing Address - Fax:302-533-6818
Practice Address - Street 1:1 INNOVATION WAY
Practice Address - Street 2:STE. 400
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711
Practice Address - Country:US
Practice Address - Phone:302-273-2247
Practice Address - Fax:302-533-6818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-13
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care