UPHAM'S CORNER HEALTH COMMITTEE INC. NPI 1780780486

NPI Information

NPI: 1780780486
Provider Name: UPHAM'S CORNER HEALTH COMMITTEE, INC.

Doing Business As: UPHAM'S CORNER HEALTH CENTER

Classification: Clinic/Center - 261QC1500X
Entity Type: Organization

Specialization: Community Health

Address:
500 COLUMBIA RD
DORCHESTER, MA
ZIP 02125
Phone: (617) 287-8000
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UPHAM'S CORNER HEALTH COMMITTEE, INC. is a community health clinic center in Dorchester, MA. UPHAM'S CORNER HEALTH COMMITTEE, INC. NPI is 1780780486. The provider is registered as an organization entity type.
The provider Is Doing Business As Upham's Corner Health Center.

The provider's business location address is:

500 COLUMBIA RD
DORCHESTER, MA
ZIP 02125-322
Phone: (617) 287-8000
Fax: (617) 282-8625

The provider's authorized official is Jagdeep Trivedi .
The authorized official title is Ceo and has the following contact phone number (617) 740-8131.

The enumeration date for this NPI number is 9/16/2006 and was last updated on 7/12/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	291U00000X	Clinical Medical Laboratory				No
2	292200000X	Dental Laboratory				No
3	261QD0000X	Clinic/Center	Dental			No
4	261QF0050X	Clinic/Center	Family Planning, Non-Surgical			No
5	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	490	MASSACHUSETTS	No
6	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			No
7	261QM2500X	Clinic/Center	Medical Specialty			No
8	261QP1100X	Clinic/Center	Podiatric			No
9	261QP2300X	Clinic/Center	Primary Care			No
10	261QU0200X	Clinic/Center	Urgent Care			No
11	261QC1500X	Clinic/Center	Community Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1301977	MEDICAID	MASSACHUSETTS
2	221828	MEDICARE ID-TYPE UNSPECIFIED

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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