NPIMap

Organization Active NPI

Family Care Medical Center Laboratory

  • Clinical Medical Laboratory
  • Springfield, MA
National Provider Identifier
1902094568
Registry record updated Oct 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
2483 Issued in MA
Legal business name
FAMILY CARE MEDICAL CENTER LABORATORY
Practice address
1515 Allen St
Springfield, MA 01118-1803
Phone
(414) 783-9114
Fax
(413) 782-0960
NPI assigned
Oct 9, 2007
Organization subpart
Yes
Parent organization
URGENT CARE PHYSICIANS P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Patricia Ann Detomas
Title
Financial Administrator
Phone
(413) 782-6074

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 2483 MA Primary

Addresses

Primary practice location

1515 Allen St
Springfield, MA 01118-1803

Mailing address

1515 Allen St
Springfield, MA 01118-1803
Phone (413) 783-9114

Other identifiers 1

IdentifierTypeStateIssuer
M13659OtherMABLUE CROSS/BLUE SHIELD MA

National Provider Directory

National Provider Directory
Tax ID family
Urgent Care Physicians PC5 organizations share this tax ID, including this one
Part of
Urgent Care Physicians PC

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191888000000",
    "number": "1902094568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 ALLEN ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011181803",
            "telephone_number": "413-783-9114",
            "fax_number": "413-782-0960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 ALLEN ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011181803",
            "telephone_number": "414-783-9114",
            "fax_number": "413-782-0960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CARE MEDICAL CENTER LABORATORY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "URGENT CARE PHYSICIANS P.C.",
        "enumeration_date": "2007-10-09",
        "last_updated": "2007-10-09",
        "status": "A",
        "authorized_official_last_name": "DETOMAS",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "FINANCIAL ADMINISTRATOR",
        "authorized_official_telephone_number": "413-782-6074",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MA",
            "license": "2483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD MA",
            "identifier": "M13659",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.