Healthcare Provider Details

I. General information

NPI: 1902495484
Provider Name (Legal Business Name): GREEN MOUNTAIN URGENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2021
Last Update Date: 07/21/2022
Certification Date: 07/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

856 STATE RD
NORTH ADAMS MA
01247-3027
US

IV. Provider business mailing address

74 PLEASANT ST STE 204
NEW LONDON NH
03257-5881
US

V. Phone/Fax

Practice location:
  • Phone: 603-526-4635
  • Fax:
Mailing address:
  • Phone: 603-526-4635
  • Fax: 603-526-2151

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: DR. MARCUS J HAMPERS
Title or Position: MANAGING EMPLOYEE
Credential: MD
Phone: 603-526-4635