Organization
MIDLAND MEDICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN R BEAUPRE MD (MEDICAL DIRECTOR)
(401) 463-3380
Entity
Organization
Contact information
Practice address
1312 OAKLAWN AVE, CRANSTON, RI 02920
(401) 463-3380
(401) 463-3308
Mailing address
1312 OAKLAWN AVE, CRANSTON, RI 02920
(401) 463-3380
(401) 463-3308
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
RI
332B00000X
Durable Medical Equipment & Medical Supplies
1276020001
RI
332B00000X
Durable Medical Equipment & Medical Supplies
7006274
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000128
—
RI
01
—
7006274
MEDICAID DME
RI
Enumeration date
07/13/2006
Last updated
05/02/2008
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