Healthcare Provider Details

I. General information

NPI: 1437348505
Provider Name (Legal Business Name): CAROL J HAMEL, OD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2007
Last Update Date: 06/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 OLD RIVER RD STE 201
LINCOLN RI
02865-1158
US

IV. Provider business mailing address

132 OLD RIVER RD STE 201
LINCOLN RI
02865-1161
US

V. Phone/Fax

Practice location:
  • Phone: 401-721-5599
  • Fax: 401-721-5597
Mailing address:
  • Phone: 401-721-5599
  • Fax: 401-721-5597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberODTA00468
License Number StateRI

VIII. Authorized Official

Name: RACHEL B PAILTHORPE
Title or Position: PRACTICE MANAGER
Credential: CPO
Phone: 401-721-5599