Healthcare Provider Details
I. General information
NPI: 1023304656
Provider Name (Legal Business Name): HEALTH CLINIC INC URGENT CARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/22/2011
Last Update Date: 06/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1155 PURCHASE ST
NEW BEDFORD MA
02740-6634
US
IV. Provider business mailing address
427 PLYMOUTH AVE
FALL RIVER MA
02721-4231
US
V. Phone/Fax
- Phone: 508-997-2900
- Fax: 508-991-4432
- Phone: 508-679-0010
- Fax: 508-672-4679
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | M51540 |
| License Number State | MA |
VIII. Authorized Official
Name: DR.
TUSHAR
C.
PATEL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 508-679-0010