| Organization Name: | CREST URGENT CARE |
| NPI Number: | 1073813713 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMES O'HAIR (DIRECTOR) |
| Mailing Address: | 100 Smithfield Ave Pawtucket |
| State: | RI US |
| Postal Code: | 028603497 |
| Phone Number: | 4017258600 |
| Fax Number: | 1401725806 |
| NPI Enumeration Date: | 10/28/2010 |
| NPI Last Update Date: | 10/28/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | PA00565 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | RI |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |