Provider Demographics
NPI:1093268260
Name:PATRIOT URGENT CARE PROFESSIONALS, PC
Entity Type:Organization
Organization Name:PATRIOT URGENT CARE PROFESSIONALS, PC
Other - Org Name:AFC URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:G
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-459-5100
Mailing Address - Street 1:1030 MAIN ST
Mailing Address - Street 2:UNIT 2
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-7447
Mailing Address - Country:US
Mailing Address - Phone:781-894-6900
Mailing Address - Fax:781-894-6901
Practice Address - Street 1:160 GREAT ROAD
Practice Address - Street 2:UNIT 4A
Practice Address - City:BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:01730
Practice Address - Country:US
Practice Address - Phone:617-459-5100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-25
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care