Organization
OCEAN STATE PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FARHAT IBRAHIM MD (MD)
(401) 739-4350
Entity
Organization
Contact information
Practice address
300 TOLL GATE RD STE 202, WARWICK, RI 02886-4447
(401) 739-4350
(401) 739-3759
Mailing address
300 TOLL GATE RD STE 202, WARWICK, RI 02886-4447
(401) 739-4350
(401) 739-3759
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD10008
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2499
NHP
—
01
—
309562
BCBS
—
01
—
400337
TUFTS
—
01
—
404939
B CHIP
—
05
—
9004697
—
RI
Enumeration date
11/15/2006
Last updated
07/22/2021
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