Provider Demographics
NPI:1023304656
Name:HEALTH CLINIC INC URGENT CARE
Entity type:Organization
Organization Name:HEALTH CLINIC INC URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TUSHAR
Authorized Official - Middle Name:C
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-679-0010
Mailing Address - Street 1:427 PLYMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02721-4231
Mailing Address - Country:US
Mailing Address - Phone:508-679-0010
Mailing Address - Fax:508-672-4679
Practice Address - Street 1:1155 PURCHASE ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-6634
Practice Address - Country:US
Practice Address - Phone:508-997-2900
Practice Address - Fax:508-991-4432
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH CLINIC INC DBA METROMEDIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAM51540261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
M21021Medicare PIN
D82905Medicare UPIN