Provider Demographics
NPI:1144407529
Name:WOONSOCKET URGENT CARE
Entity Type:Organization
Organization Name:WOONSOCKET URGENT CARE
Other - Org Name:WOONSOCKET PRIMARY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:VALLERA
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:781-255-0500
Mailing Address - Street 1:103 PROVIDENCE HWY
Mailing Address - Street 2:
Mailing Address - City:EAST WALPOLE
Mailing Address - State:MA
Mailing Address - Zip Code:02032-1512
Mailing Address - Country:US
Mailing Address - Phone:781-255-0500
Mailing Address - Fax:401-766-2770
Practice Address - Street 1:25 JOHN A CUMMINGS WAY
Practice Address - Street 2:3RD FLOOR
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-3224
Practice Address - Country:US
Practice Address - Phone:401-766-2700
Practice Address - Fax:401-766-2770
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WOONSOCKET URGENT CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-28
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty