Provider Demographics
NPI:1942069893
Name:SIGNATURE HEALTHCARE URGENT CARE, INC.
Entity Type:Organization
Organization Name:SIGNATURE HEALTHCARE URGENT CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:HAFFEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-941-7001
Mailing Address - Street 1:680 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02302-3308
Mailing Address - Country:US
Mailing Address - Phone:941-741-7000
Mailing Address - Fax:
Practice Address - Street 1:110 LIBERTY ST STE 1C
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-5674
Practice Address - Country:US
Practice Address - Phone:508-941-7100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SIGNATURE HEALTHCARE URGENT CARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-03-14
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care