1720497985 NPI number — URGENT CARE SPECIALISTS, P.C.

Table of content: (NPI 1720497985)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720497985 NPI number — URGENT CARE SPECIALISTS, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
URGENT CARE SPECIALISTS, P.C.
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:
1720497985
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/22/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5 SHREWSBURY ST STE D
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOLDEN
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01520-1960
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-829-3800
Provider Business Mailing Address Fax Number:
508-829-3802

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5 SHREWSBURY ST STE D
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOLDEN
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01520-1960
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-829-3800
Provider Business Practice Location Address Fax Number:
508-829-3802
Provider Enumeration Date:
08/12/2014

Additional Information

Authorized Official

Authorized Official Last Name:
ADAMS
Authorized Official First Name:
JASON
Authorized Official Middle Name:
L
Authorized Official Title or Position:
PRACTICE ADMINISTRATOR
Authorized Official Telephone Number:
508-829-3808

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)

  • Identifier: 6769740001 . This is a "DMEPOS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 843159 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: AA289049 . This is a "HPHC" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 110094755A , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: V236166769740001 . This is a "NETWORK HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0029575 . This is a "MEDICARE PTAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 56480 . This is a "HNE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: DT8769 . This is a "RRMC" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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