Provider Demographics
NPI:1467709014
Name:EPOCH FAMILY MEDICINE, LLC
Entity Type:Organization
Organization Name:EPOCH FAMILY MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-338-3525
Mailing Address - Street 1:60 BAY SPRING AVE
Mailing Address - Street 2:#B6
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-1386
Mailing Address - Country:US
Mailing Address - Phone:401-338-3525
Mailing Address - Fax:404-698-2521
Practice Address - Street 1:60 BAY SPRING AVE
Practice Address - Street 2:#B6
Practice Address - City:BARRINGTON
Practice Address - State:RI
Practice Address - Zip Code:02806-1386
Practice Address - Country:US
Practice Address - Phone:401-338-3525
Practice Address - Fax:404-698-2521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-13
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD11566207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty