Provider Demographics
NPI:1982381018
Name:UMASS MEMORIAL MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:UMASS MEMORIAL MEDICAL GROUP, INC.
Other - Org Name:URGENT CARE EXPRESS AT HARRINGTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP/COO
Authorized Official - Prefix:
Authorized Official - First Name:GERALDINE
Authorized Official - Middle Name:
Authorized Official - Last Name:VAUGHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:774-442-1520
Mailing Address - Street 1:PO BOX 415348
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-5348
Mailing Address - Country:US
Mailing Address - Phone:800-225-8885
Mailing Address - Fax:508-334-1977
Practice Address - Street 1:78 SUTTON AVE
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MA
Practice Address - Zip Code:01540-1813
Practice Address - Country:US
Practice Address - Phone:508-499-1760
Practice Address - Fax:508-499-1757
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UMASS MEMORIAL MEDICAL GROUP, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-06-30
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care