# OCEAN STATE PRIMARY CARE CENTER OF EAST PROVIDENCE INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225543754
- **Authorized official:** JENNIFER ZUBA (GENERAL MANAGER)
- **Authorized official phone:** (401) 626-2748

## Contact information

- **Practice address:** 450 VETERANS MEMORIAL PKWY UNIT 15B, EAST PROVIDENCE, RI 02914-5300
- **Practice address phone:** (401) 434-3350
- **Mailing address:** 2130 MENDON RD STE 3-333, CUMBERLAND, RI 02864-3844
- **Mailing address phone:** (401) 353-1012
- **Mailing address fax:** (401) 353-6362

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 12/06/2017
- **Last updated:** 12/06/2017