MEDICARE: MASS GENERAL BRIGHAM URGENT CARE LLC

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	:	1609387695
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MASS GENERAL BRIGHAM URGENT CARE LLC

Provider Business Mailing Address
First Line	:	399 REVOLUTION DR
Second Line	:
City	:	SOMERVILLE
State	:	MA
Zip	:	02145-1484
Country	:	US
Telephone Number	:	888-980-0505
Fax Number	:

Provider Business Practice Location Address
First Line	:	1815 MASSACHUSETTS AVE
Second Line	:
City	:	CAMBRIDGE
State	:	MA
Zip	:	02140-1430
Country	:	US
Telephone Number	:	857-856-5770
Fax Number	:

Authorized Official
Title or Position	:	SENIOR DIRECTOR
Name	:	KEVIN ROBERT MULCAHY
Credential	:
Telephone Number	:	617-724-9245

Provider Enumeration Date	:	10/17/2017
Last Update Date	:	07/27/2021

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