=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437348505
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CAROL J HAMEL, OD INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/15/2007
-----------------------------------------------------
Last Update Date | 06/03/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 132 OLD RIVER RD STE 201
-----------------------------------------------------
City | LINCOLN
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02865-1158
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-721-5599
-----------------------------------------------------
Fax | 401-721-5597
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 132 OLD RIVER RD STE 201
-----------------------------------------------------
City | LINCOLN
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02865-1161
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-721-5599
-----------------------------------------------------
Fax | 401-721-5597
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRACTICE MANAGER
-----------------------------------------------------
Name | RACHEL B PAILTHORPE
-----------------------------------------------------
Credential | CPO
-----------------------------------------------------
Telephone | 401-721-5599
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | ODTA00468
-----------------------------------------------------
License Number State | RI
-----------------------------------------------------