Provider Demographics
NPI:1578666368
Name:TAUNTON WALK IN HEALTHCLINIC
Entity Type:Organization
Organization Name:TAUNTON WALK IN HEALTHCLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HARSHAD
Authorized Official - Middle Name:M
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-822-2311
Mailing Address - Street 1:1 TREMONT ST
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-3054
Mailing Address - Country:US
Mailing Address - Phone:508-822-2311
Mailing Address - Fax:
Practice Address - Street 1:1 TREMONT ST
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-3054
Practice Address - Country:US
Practice Address - Phone:508-822-2311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA52109261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9787402Medicaid
MA610240OtherTUFTS HEALTHPLAN
MA6690551OtherUNITED HEALTH
MAS403OtherHARVARD PILGRIM
MA000000023389OtherBOSTON MEDICAL HEALTH PLA
MAM16362OtherMASS BC AND BS
MA6690551OtherUNITED HEALTH
MA9787402Medicaid