Basic Information
| Provider Information | |||||||||
| NPI: | 1538659081 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TRUCARE INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 725 RESERVOIR AVE STE 6A | ||||||||
| Address2: | |||||||||
| City: | CRANSTON | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029104450 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4019446889 | ||||||||
| FaxNumber: | 4019446726 | ||||||||
| Practice Location | |||||||||
| Address1: | 725 RESERVOIR AVE STE 6A | ||||||||
| Address2: | |||||||||
| City: | CRANSTON | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029104450 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4019446889 | ||||||||
| FaxNumber: | 4019446726 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2018 | ||||||||
| LastUpdateDate: | 05/10/2018 | ||||||||
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| AuthorizedOfficialLastName: | SANTORO | ||||||||
| AuthorizedOfficialFirstName: | RALPH | ||||||||
| AuthorizedOfficialMiddleName: | FRANK | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4019446889 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD11412 | RI | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.