MEDICARE: PATRIOT URGENT CARE PROFESSIONALS 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	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1457188435
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATRIOT URGENT CARE PROFESSIONALS PC

Provider Business Mailing Address
First Line	:	154 GREAT RD
Second Line	:
City	:	BEDFORD
State	:	MA
Zip	:	01730-2725
Country	:	US
Telephone Number	:	774-400-4084
Fax Number	:	605-558-0132

Provider Business Practice Location Address
First Line	:	117 STAFFORD ST
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01603-1478
Country	:	US
Telephone Number	:	774-400-4084
Fax Number	:	605-558-0132

Authorized Official
Title or Position	:	SECRETARY
Name	:	MR. DAVID G ADAMS
Credential	:
Telephone Number	:	781-431-8161

Provider Enumeration Date	:	09/16/2024
Last Update Date	:	09/16/2024

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