Provider Demographics
NPI:1699896746
Name:HARBOUR MEDICAL
Entity type:Organization
Organization Name:HARBOUR MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:URBAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:401-885-6636
Mailing Address - Street 1:1000 DIVISION ST.
Mailing Address - Street 2:HARBOUR MEDICAL SUITE #70
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818
Mailing Address - Country:US
Mailing Address - Phone:401-885-6636
Mailing Address - Fax:401-885-4681
Practice Address - Street 1:1000 DIVISION ST
Practice Address - Street 2:HARBOUR MEDICAL SUITE #70
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-2008
Practice Address - Country:US
Practice Address - Phone:401-885-6636
Practice Address - Fax:401-885-4681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2009-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRI09760261QP2300X, 261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI9002582Medicaid
RIH20762Medicare UPIN
RI119002905Medicare PIN