Healthcare Provider Details

I. General information

NPI: 1841377629
Provider Name (Legal Business Name): BRISTOL COUNTY OPEN MRI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1182 HOPE ST
BRISTOL RI
02809-1126
US

IV. Provider business mailing address

71 SANDY BOTTOM RD
COVENTRY RI
02816-5863
US

V. Phone/Fax

Practice location:
  • Phone: 401-253-6740
  • Fax: 401-253-6710
Mailing address:
  • Phone: 401-822-0300
  • Fax: 401-822-0701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: VIRGINIA CARR
Title or Position: OFFICE MANAGER4018220300
Credential:
Phone: 401-822-0300