# COUNTY LINE URGENT CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205436516
- **Authorized official:** DR. NORMAN INDICH MD (OWNER)
- **Authorized official phone:** (732) 730-9111

## Contact information

- **Practice address:** 603 W COUNTY LINE RD, LAKEWOOD, NJ 08701-1216
- **Practice address phone:** (732) 730-9111
- **Practice address fax:** (732) 595-1330
- **Mailing address:** 603 W COUNTY LINE RD, LAKEWOOD, NJ 08701-1216
- **Mailing address phone:** (732) 730-9111
- **Mailing address fax:** (732) 595-1330

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/27/2020
- **Last updated:** 10/27/2020