Healthcare Provider Details

I. General information

NPI: 1730588062
Provider Name (Legal Business Name): OCEAN STATE URGENT CARE CENTER OF WOONSOCKET
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2014
Last Update Date: 02/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 JOHN A CUMMINGS WAY
WOONSOCKET RI
02895-3244
US

IV. Provider business mailing address

25 JOHN A CUMMINGS WAY
WOONSOCKET RI
02895-3244
US

V. Phone/Fax

Practice location:
  • Phone: 401-235-7310
  • Fax: 401-235-7314
Mailing address:
  • Phone: 401-235-7310
  • Fax: 401-235-7314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateRI
# 4
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberMD08003
License Number StateRI
# 6
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: FRANK D'ALESSANDRO
Title or Position: MANAGING PARTNER
Credential: MD
Phone: 401-333-9595