Provider Demographics
NPI:1649579707
Name:URGENT CARE PHYSICIANS, P.C.
Entity Type:Organization
Organization Name:URGENT CARE PHYSICIANS, P.C.
Other - Org Name:FAMILY CARE MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:GALLANT
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:413-783-9114
Mailing Address - Street 1:1515 ALLEN ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01118-1803
Mailing Address - Country:US
Mailing Address - Phone:413-783-9114
Mailing Address - Fax:413-782-0960
Practice Address - Street 1:1515 ALLEN ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01118-1803
Practice Address - Country:US
Practice Address - Phone:413-783-9114
Practice Address - Fax:413-782-0960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-15
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM13695Medicare UPIN