Provider First Line Business Practice Location Address:
200 HIGH SERVICE AVE
Provider Second Line Business Practice Location Address:
OUR LADY OF FATIMA HOSPITAL
Provider Business Practice Location Address City Name:
NORTH PROVIDENCE
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02904-5113
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-456-3000
Provider Business Practice Location Address Fax Number:
401-456-3402
Provider Enumeration Date:
11/11/2005