Provider Demographics
NPI:1326669151
Name:MASS GENERAL BRIGHAM URGENT CARE LLC
Entity Type:Organization
Organization Name:MASS GENERAL BRIGHAM URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:MULCAHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-724-9245
Mailing Address - Street 1:399 REVOLUTION DR
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02145-1444
Mailing Address - Country:US
Mailing Address - Phone:617-724-9245
Mailing Address - Fax:
Practice Address - Street 1:480 LYNNFIELD ST STE 1A
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01904-1419
Practice Address - Country:US
Practice Address - Phone:978-354-3943
Practice Address - Fax:978-354-3954
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MASS GENERAL BRIGHAM URGENT CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-05-04
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care