Healthcare Provider Details

I. General information

NPI: 1497829253
Provider Name (Legal Business Name): HEALTH CLINIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 05/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 PURCHASE ST
NEW BEDFORD MA
02740
US

IV. Provider business mailing address

429 PLYMOUTH AVE
FALL RIVER MA
02721
US

V. Phone/Fax

Practice location:
  • Phone: 508-997-2900
  • Fax: 508-991-4432
Mailing address:
  • Phone: 508-679-0010
  • Fax: 508-672-4679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: TUSHAR C PATEL
Title or Position: OWNER
Credential: MD
Phone: 508-997-2900