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General NPI Number Information
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NPI Number | 1922887157
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Entity Type | Organization
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Legal Business Name | MDRI LLC
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Dates
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Enumeration Date | 09/26/2023
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Last Update Date | 03/29/2025
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Provider Practice Location Address
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Address Line | 1407 S COUNTY TRL STE 432
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City | EAST GREENWICH
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State | RI
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Zip | 02818-1679
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Country | US
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Telephone | 401-398-0288
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Fax | 401-471-7365
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Provider Business Mailing Address
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Address Line | 1407 S COUNTY TRL STE 431
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City | EAST GREENWICH
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State | RI
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Zip | 02818-1679
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Country | US
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Telephone | 401-398-0288
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Fax | 401-471-7365
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | DESIREE COFFEY
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Credential |
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Telephone | 401-398-0288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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