Organization Name: | OCEAN STATE URGENT CARE CENTER OF COVENTRY, LLC |
NPI Number: | 1013302488 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN H. MARTIN (MANAGING PARTNER) |
Mailing Address: | 982 Tiogue Ave Coventry |
State: | RI US |
Postal Code: | 028166116 |
Phone Number: | 4018216800 |
Fax Number: | |
NPI Enumeration Date: | 04/02/2015 |
NPI Last Update Date: | 04/02/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QU0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Urgent Care |
Taxonomy Definition: |