MEDICARE: CAREWELL URGENT CARE CENTERS OF MA, P.C

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		MA

General Provider Information

NPI Number	:	1568875169
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAREWELL URGENT CARE CENTERS OF MA, P.C

Provider Business Mailing Address
First Line	:	2 ADAMS PL
Second Line	:	STE 305
City	:	QUINCY
State	:	MA
Zip	:	02169-7456
Country	:	US
Telephone Number	:	617-302-4194
Fax Number	:

Provider Business Practice Location Address
First Line	:	349 BROADWAY
Second Line	:
City	:	SOMERVILLE
State	:	MA
Zip	:	02145-2407
Country	:	US
Telephone Number	:	617-477-8755
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	JOHN CORNWELL
Credential	:	M.D
Telephone Number	:	617-302-4194

Provider Enumeration Date	:	06/11/2014
Last Update Date	:	07/01/2014

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