1477675262 NPI number — RHODE ISLAND HOSPITAL

Table of content: (NPI 1477675262)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477675262 NPI number — RHODE ISLAND HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RHODE ISLAND HOSPITAL
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:
LIFESPAN CANCER INSTITUTE--LINCOLN INFUSION CENTER
Provider Other Organization Name Type Code:
5
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:
1477675262
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/05/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
117 ELLENFIELD ST STE 101
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PROVIDENCE
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02905-4541
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-444-6779
Provider Business Mailing Address Fax Number:
401-444-6912

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
701 GEORGE WASHINGTON HWY STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LINCOLN
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02865
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
844-222-2881
Provider Business Practice Location Address Fax Number:
401-444-5256
Provider Enumeration Date:
04/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MARKELL
Authorized Official First Name:
PETER
Authorized Official Middle Name:
K
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
401-444-7914

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: HE36048 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".




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