Organization
UPHAM'S CORNER HEALTH COMMITTEE, INC.
Active
Other names
Upham's Corner Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAGDEEP TRIVEDI (CEO)
(617) 740-8131
Entity
Organization
Contact information
Practice address
500 COLUMBIA RD, DORCHESTER, MA 02125-2322
(617) 287-8000
(617) 282-8625
Mailing address
500 COLUMBIA RD, DORCHESTER, MA 02125-2322
(617) 287-8000
(617) 282-8625
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
261QF0050X
Non-Surgical Family Planning Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
490
MA
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
261QP1100X
Podiatric Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
291U00000X
Clinical Medical Laboratory
—
—
292200000X
Dental Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1301977
—
MA
Enumeration date
09/16/2006
Last updated
07/12/2017
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