Healthcare Provider Details
I. General information
NPI: 1134050461
Provider Name (Legal Business Name): CARBON HEALTH URGENT CARE OF MASSACHUSETTS PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
578 HUNTINGTON AVE STE 2
BOSTON MA
02115-5902
US
IV. Provider business mailing address
PO BOX 210
PORTSMOUTH NH
03802-0210
US
V. Phone/Fax
- Phone: 508-283-9775
- Fax: 617-221-9960
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARLEY
PAGE
Title or Position: DIRECTOR OF CONTRACTING
Credential:
Phone: 417-861-9739