Healthcare Provider Details

I. General information

NPI: 1174350201
Provider Name (Legal Business Name): PATRIOT URGENT CARE PROFESSIONALS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2024
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1312 BOSTON RD
SPRINGFIELD MA
01119-1336
US

IV. Provider business mailing address

154 GREAT RD
BEDFORD MA
01730-2725
US

V. Phone/Fax

Practice location:
  • Phone: 774-400-4084
  • Fax: 605-558-0132
Mailing address:
  • Phone: 774-400-4084
  • Fax: 605-558-0132

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: MR. DAVID G ADAMS
Title or Position: SECRETARY
Credential:
Phone: 781-430-8161