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NPI Code Detail

MEDICARE: WOONSOCKET URGENT CARE PC

MEDICARE: WOONSOCKET URGENT CARE PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician
2261QU0200XUrgent Care Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083006738
Entity Type Code : Organization
Provider Name (Legal Business Name) : WOONSOCKET URGENT CARE PC
Provider Business Mailing Address
First Line : 103 PROVIDENCE HWY
Second Line :
City : EAST WALPOLE
State : MA
Zip : 02032-1512
Country : US
Telephone Number : 781-255-0500
Fax Number : 781-255-0400
Provider Business Practice Location Address
First Line : 103 PROVIDENCE HWY
Second Line :
City : EAST WALPOLE
State : MA
Zip : 02032-1512
Country : US
Telephone Number : 781-255-0500
Fax Number : 781-255-0400
Authorized Official
Title or Position : CEO
Name : MR. PAUL VALLERA
Credential : P.A.
Telephone Number : 781-255-0500
Provider Enumeration Date : 03/04/2015
Last Update Date : 02/15/2024

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1871012468 — FIONA DEBRA JOHANSMEYER PA
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Directions to “WOONSOCKET URGENT CARE PC ” Practice Location

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