Provider Demographics
NPI:1730588062
Name:OCEAN STATE URGENT CARE CENTER OF WOONSOCKET
Entity type:Organization
Organization Name:OCEAN STATE URGENT CARE CENTER OF WOONSOCKET
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:D'ALESSANDRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-333-9595
Mailing Address - Street 1:25 JOHN A CUMMINGS WAY
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-3244
Mailing Address - Country:US
Mailing Address - Phone:401-235-7310
Mailing Address - Fax:401-235-7314
Practice Address - Street 1:25 JOHN A CUMMINGS WAY
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-3244
Practice Address - Country:US
Practice Address - Phone:401-235-7310
Practice Address - Fax:401-235-7314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-22
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI207R00000X
363LF0000X, 363A00000X, 207K00000X, 207KA0200X, 207RP1001X
RIMD08003261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty