Healthcare Provider Details

I. General information

NPI: 1649102229
Provider Name (Legal Business Name): TRUE NORTH MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2026
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 JEFFERSON BLVD
WARWICK RI
02888-3852
US

IV. Provider business mailing address

21 JOHNSON PL
SOUTH KINGSTOWN RI
02879-4001
US

V. Phone/Fax

Practice location:
  • Phone: 508-685-2525
  • Fax:
Mailing address:
  • Phone: 508-685-2525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER NITANYA BARLOW
Title or Position: PRESIDENT
Credential: APRN
Phone: 508-685-2525