Provider Demographics
NPI:1568875169
Name:CAREWELL URGENT CARE CENTERS OF MA, P.C
Entity Type:Organization
Organization Name:CAREWELL URGENT CARE CENTERS OF MA, P.C
Other - Org Name:CAREWELL URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:CORNWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-302-4194
Mailing Address - Street 1:2 ADAMS PL
Mailing Address - Street 2:STE 305
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-7456
Mailing Address - Country:US
Mailing Address - Phone:617-302-4194
Mailing Address - Fax:
Practice Address - Street 1:349 BROADWAY
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02145-2407
Practice Address - Country:US
Practice Address - Phone:617-477-8755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-11
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care