| Organization Name: | ADVANCED URGENT CARE OF WILLOW GROVE LLC |
| NPI Number: | 1104207612 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MEHDI NIKPARVARFARD (OWNER) |
| Mailing Address: | 126 Easton Rd Willow Grove |
| State: | PA US |
| Postal Code: | 190903203 |
| Phone Number: | 2153667437 |
| Fax Number: | 2676072921 |
| NPI Enumeration Date: | 06/11/2015 |
| NPI Last Update Date: | 06/11/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QU0200X |
| License Number: | MD424252 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Urgent Care |
| Taxonomy Definition: | |