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General NPI Number Information
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NPI Number | 1508226515
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Entity Type | Organization
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Legal Business Name | OCEAN STATE URGENT CARE CENTER OF BARRINGTON, LLC
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Dates
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Enumeration Date | 03/03/2016
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Last Update Date | 03/20/2017
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Provider Practice Location Address
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Address Line | 310 MAPLE AVE
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City | BARRINGTON
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State | RI
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Zip | 02806-3430
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Country | US
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Telephone | 401-289-0011
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Fax |
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Provider Business Mailing Address
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Address Line | 2130 MENDON RD SUITE 3-333
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City | CUMBERLAND
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State | RI
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Zip | 02864-3844
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | JONATHAN MARTIN
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Credential | MD
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Telephone | 401-334-3105
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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