Provider Demographics
NPI:1730420738
Name:ORTHOPEDIC URGENT CARE LLC
Entity type:Organization
Organization Name:ORTHOPEDIC URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:BLAZAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-722-2400
Mailing Address - Street 1:588 PAWTUCKET AVE
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-6057
Mailing Address - Country:US
Mailing Address - Phone:401-722-2400
Mailing Address - Fax:401-728-3920
Practice Address - Street 1:588 PAWTUCKET AVE
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-6057
Practice Address - Country:US
Practice Address - Phone:401-722-2400
Practice Address - Fax:401-728-3920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-15
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care