| Ocean Medical Practice, Inc. | |
|
20 Cumberland Hill Rd Suite 208 Woonsocket RI 02895-4854 | |
| (401) 765-1200 | |
| (401) 765-1212 |
| Full Name | Ocean Medical Practice, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 20 Cumberland Hill Rd, Woonsocket, Rhode Island |
| Authorized Official Name and Position | Jibran Khan (PRESIDENT) |
| Authorized Official Contact | 4017651200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ocean Medical Practice, Inc. 20 Cumberland Hill Rd Suite 208 Woonsocket RI 02895-4854 Ph: (401) 765-1200 | Ocean Medical Practice, Inc. 20 Cumberland Hill Rd Suite 208 Woonsocket RI 02895-4854 Ph: (401) 765-1200 |
| NPI Number | 1043401979 |
|---|---|
| Provider Enumeration Date | 08/06/2007 |
| Last Update Date | 04/01/2008 |
| Medicare PECOS PAC ID | 6800857343 |
|---|---|
| Medicare Enrollment ID | O20041019000918 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043401979 | NPI | - | NPPES |
| OM69208 | Medicaid | RI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 9516 (Rhode Island) | Primary |
| Provider Name | Jibran Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902803935 PECOS PAC ID: 2062472509 Enrollment ID: I20041019000141 |
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