Healthcare Provider Details

I. General information

NPI: 1699212340
Provider Name (Legal Business Name): MASS GENERAL BRIGHAM URGENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2017
Last Update Date: 07/27/2021
Certification Date: 07/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 STUART ST SUITE A-7
BOSTON MA
02116-5609
US

IV. Provider business mailing address

399 REVOLUTION DR
SOMERVILLE MA
02145-1484
US

V. Phone/Fax

Practice location:
  • Phone: 888-980-0505
  • Fax:
Mailing address:
  • Phone: 888-980-0505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KEVIN ROBERT MULCAHY
Title or Position: SENIOR DIRECTOR
Credential:
Phone: 617-724-9245