1801889035 NPI number — STATE OF RHODE ISLAND

Table of content: (NPI 1801889035)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801889035 NPI number — STATE OF RHODE ISLAND

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STATE OF RHODE ISLAND
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ELEANOR SLATER HOSPITAL
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801889035
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/02/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 8293
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CRANSTON
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02920-0293
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-462-1405
Provider Business Mailing Address Fax Number:
401-462-3555

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
111 HOWARD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CRANSTON
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02920-3001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-462-1405
Provider Business Practice Location Address Fax Number:
401-462-3555
Provider Enumeration Date:
08/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
CHAREST
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
R
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
401-462-0660

Provider Taxonomy Codes

  • Taxonomy code: 282E00000X , with the licence number:  HOS00102 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: CP00402578 001 . This is a "MEDICARE CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00004102001 . This is a "HEALTHMATE 2000" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 000000 2900-001 . This is a "BLUE SHIELD & PLAN 65" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 0000000027 . This is a "BLUE CROSS PLAN 65" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 4102001 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 53-09425 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: RI22693 . This is a "RI MED CTR PHY GROUP" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com