Healthcare Provider Details

I. General information

NPI: 1316771447
Provider Name (Legal Business Name): WELLNESS CONNECT URGENT CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2024
Last Update Date: 08/30/2024
Certification Date: 08/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 BROAD ST STE 201
PROVIDENCE RI
02907-1444
US

IV. Provider business mailing address

655 BROAD ST STE 201
PROVIDENCE RI
02907-1444
US

V. Phone/Fax

Practice location:
  • Phone: 401-642-0100
  • Fax:
Mailing address:
  • Phone: 401-642-0100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MIRIANNYS RIVAS
Title or Position: CEO
Credential: NURSE PRACTITIONER
Phone: 401-642-0100