Provider Demographics
NPI:1376820589
Name:OCEAN STATE MEDICAL, LLC
Entity Type:Organization
Organization Name:OCEAN STATE MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRED
Authorized Official - Middle Name:F
Authorized Official - Last Name:FERRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-272-3410
Mailing Address - Street 1:1539 ATWOOD AVE, STE. 101
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-3262
Mailing Address - Country:US
Mailing Address - Phone:401-272-3410
Mailing Address - Fax:401-272-3417
Practice Address - Street 1:1539 ATWOOD AVE STE 101
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-3262
Practice Address - Country:US
Practice Address - Phone:401-272-3410
Practice Address - Fax:401-272-3417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-16
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRI6753207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty