1982072260 NPI number — CAREWELL URGENT CARE CENTERS OF MA, PC

Table of content: MRS. ANNMARIE THOMPSON LMSW (NPI 1003655564)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982072260 NPI number — CAREWELL URGENT CARE CENTERS OF MA, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAREWELL URGENT CARE CENTERS OF MA, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982072260
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/04/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2 ADAMS PL
Provider Second Line Business Mailing Address:
SUITE 305
Provider Business Mailing Address City Name:
QUINCY
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02169-7456
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-302-4194
Provider Business Mailing Address Fax Number:
617-481-9587

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
333 SW CUTOFF
Provider Second Line Business Practice Location Address:
UNIT 202
Provider Business Practice Location Address City Name:
NORTHBOROUGH
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01532-2130
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-302-4194
Provider Business Practice Location Address Fax Number:
617-481-9587
Provider Enumeration Date:
09/03/2015

Additional Information

Authorized Official

Authorized Official Last Name:
CORNWELL
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
MM
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
617-302-4194

Provider Taxonomy Codes

  • Taxonomy code: 261QU0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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