Provider Demographics
NPI:1528221470
Name:NORTH PROVIDENCE URGENT CARE
Entity Type:Organization
Organization Name:NORTH PROVIDENCE URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:G
Authorized Official - Last Name:FARINA
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:401-353-1999
Mailing Address - Street 1:1830 MINERAL SPRING AVE
Mailing Address - Street 2:
Mailing Address - City:N PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-3864
Mailing Address - Country:US
Mailing Address - Phone:401-353-1999
Mailing Address - Fax:401-270-3080
Practice Address - Street 1:1830 MINERAL SPRING AVE
Practice Address - Street 2:
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904
Practice Address - Country:US
Practice Address - Phone:401-353-1999
Practice Address - Fax:401-270-3080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-09
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
F96933Medicare UPIN
RI007010478Medicare PIN
RI6319880001Medicare NSC