Provider Demographics
NPI:1568299691
Name:PATRIOT URGENT CARE PROFESSIONALS PC
Entity type:Organization
Organization Name:PATRIOT URGENT CARE PROFESSIONALS PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:G
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-430-8161
Mailing Address - Street 1:154 GREAT RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01730-2725
Mailing Address - Country:US
Mailing Address - Phone:774-400-4084
Mailing Address - Fax:605-558-0132
Practice Address - Street 1:18 UNION ST
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-3317
Practice Address - Country:US
Practice Address - Phone:774-400-4084
Practice Address - Fax:605-558-0132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care