Healthcare Provider Details

I. General information

NPI: 1699896746
Provider Name (Legal Business Name): HARBOUR MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 07/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 DIVISION ST HARBOUR MEDICAL SUITE #70
EAST GREENWICH RI
02818-2008
US

IV. Provider business mailing address

1000 DIVISION ST. HARBOUR MEDICAL SUITE #70
EAST GREENWICH RI
02818
US

V. Phone/Fax

Practice location:
  • Phone: 401-885-6636
  • Fax: 401-885-4681
Mailing address:
  • Phone: 401-885-6636
  • Fax: 401-885-4681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberRI09760
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberRI09760
License Number StateRI

VIII. Authorized Official

Name: DR. JAMES ROBERT URBAN JR.
Title or Position: OWNER AND OPERATOR
Credential: M.D.
Phone: 401-885-6636