# UPHAM'S CORNER HEALTH COMMITTEE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Upham's Corner Health Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780780486
- **Authorized official:** MR. JAGDEEP TRIVEDI (CEO)
- **Authorized official phone:** (617) 740-8131

## Contact information

- **Practice address:** 500 COLUMBIA RD, DORCHESTER, MA 02125-2322
- **Practice address phone:** (617) 287-8000
- **Practice address fax:** (617) 282-8625
- **Mailing address:** 500 COLUMBIA RD, DORCHESTER, MA 02125-2322
- **Mailing address phone:** (617) 287-8000
- **Mailing address fax:** (617) 282-8625

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | — | NULL | Yes |
| 261QD0000X | Dental Clinic/Center | — | NULL | — |
| 261QF0050X | Non-Surgical Family Planning Clinic/Center | — | NULL | — |
| 261QF0400X | Federally Qualified Health Center (FQHC) | 490 | MA | — |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | — |
| 261QP1100X | Podiatric Clinic/Center | — | NULL | — |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | — |
| 291U00000X | Clinical Medical Laboratory | — | NULL | — |
| 292200000X | Dental Laboratory | — | NULL | — |

## Other

- **Enumeration date:** 09/16/2006
- **Last updated:** 07/12/2017