Provider Demographics
NPI:1134410319
Name:CMC D/B/A URGENT CARE AT BEDFORD MEDICAL PARK
Entity type:Organization
Organization Name:CMC D/B/A URGENT CARE AT BEDFORD MEDICAL PARK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EVP/CFO
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:DUDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-663-6180
Mailing Address - Street 1:195 MCGREGOR ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-3748
Mailing Address - Country:US
Mailing Address - Phone:603-314-4567
Mailing Address - Fax:
Practice Address - Street 1:5 WASHINGTON PLACE
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110
Practice Address - Country:US
Practice Address - Phone:603-314-4567
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CATHOLIC MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-04-22
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty