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
1	207R00000X	Internal Medicine Physician
2	261QU0200X	Urgent Care Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID 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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Directions to “WOONSOCKET URGENT CARE PC ” Practice Location

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