Provider Demographics
NPI:1881929586
Name:WOONSOCKET URGENT CARE, PC
Entity type:Organization
Organization Name:WOONSOCKET URGENT CARE, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:VALLERA
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:401-766-2700
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:02895-3224
Mailing Address - Country:US
Mailing Address - Phone:401-766-2700
Mailing Address - Fax:401-766-2770
Practice Address - Street 1:1210 BOSTON PROVIDENCE TPKE
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-5061
Practice Address - Country:US
Practice Address - Phone:401-766-2700
Practice Address - Fax:401-766-2770
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WOONSOCKET URGENT CARE, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-10-14
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty