Provider Demographics
NPI:1396903399
Name:TRI COUNTY UROLOGY, LLC
Entity type:Organization
Organization Name:TRI COUNTY UROLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:UCCI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-739-2984
Mailing Address - Street 1:176 TOLL GATE ROAD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-4411
Mailing Address - Country:US
Mailing Address - Phone:401-739-2984
Mailing Address - Fax:401-739-0867
Practice Address - Street 1:176 TOLL GATE ROAD
Practice Address - Street 2:SUITE 301
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4411
Practice Address - Country:US
Practice Address - Phone:401-739-2984
Practice Address - Fax:401-739-0867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-27
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRI00487174400000X
RID0487174400000X
RIDO00487174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI10246OtherNEIGHBORHOOD HEALTH PLAN OF RI
RI2969061OtherUNITED HEALTHCARE
RI8177408002OtherCIGNA
RIDN3002OtherRAILROAD MEDICARE
RI00000277938OtherBLUE SHIELD
RIAA38818OtherHARVARD PILGRIM HEALTHCARE
RITC72651Medicaid
RI10246OtherNEIGHBORHOOD HEALTH PLAN
RI7716215OtherAETNA US HEALTHCARE
RI794230OtherTUFTS HEALTH PLAN
RI022429386OtherUNITED HEALTHCARE
RI402643OtherBLUE CROSS & BLUE SHIELD OF RI
RI9021255Medicaid
RI1805526OtherUNITED HEALTHCARE
RI7716215OtherAETNA
RITC72651Medicaid
RI00000277938OtherBLUE SHIELD
RI794230OtherTUFTS HEALTH PLAN