| Ocean State Primary Care Center Of Coventry, Llc | |
|
982 Tiogue Ave Coventry RI 02816-6116 | |
| (401) 821-6800 | |
| (401) 821-8513 |
| Full Name | Ocean State Primary Care Center Of Coventry, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 982 Tiogue Ave, Coventry, Rhode Island |
| Authorized Official Name and Position | Jonathan H. Martin (MANAGING PARTNER) |
| Authorized Official Contact | 4018216800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ocean State Primary Care Center Of Coventry, Llc 982 Tiogue Ave Coventry RI 02816-6116 Ph: (401) 821-6800 | Ocean State Primary Care Center Of Coventry, Llc 982 Tiogue Ave Coventry RI 02816-6116 Ph: (401) 821-6800 |
| NPI Number | 1134514276 |
|---|---|
| Provider Enumeration Date | 04/06/2015 |
| Last Update Date | 10/11/2017 |
| Medicare PECOS PAC ID | 8123349131 |
|---|---|
| Medicare Enrollment ID | O20150603000139 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134514276 | NPI | - | NPPES |
| Provider Name | Elizabeth G Dyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942282504 PECOS PAC ID: 3173416195 Enrollment ID: I20040204000503 |
| Provider Name | Daniel F Collins |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1104874320 PECOS PAC ID: 3072406826 Enrollment ID: I20050721000290 |
| Provider Name | Anna Bunch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336149459 PECOS PAC ID: 7618996539 Enrollment ID: I20051121000056 |
| Provider Name | Micheline L Poirier-woolf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710089883 PECOS PAC ID: 4587840368 Enrollment ID: I20110511000643 |
| Provider Name | Karen A Rugg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730408220 PECOS PAC ID: 8426356692 Enrollment ID: I20160421001071 |
| Provider Name | Meaghan Brady Macrae |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457725731 PECOS PAC ID: 9436448081 Enrollment ID: I20160520000653 |
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