1578885224 NPI number — NORTHERN R I REHAB MANAGEMENT ASSOCIATES LP

Table of content: (NPI 1578885224)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578885224 NPI number — NORTHERN R I REHAB MANAGEMENT ASSOCIATES LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTHERN R I REHAB MANAGEMENT ASSOCIATES LP
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:
Provider Other Organization Name Type Code:
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:
1578885224
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/31/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
298 ARMISTICE BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PAWTUCKET
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02861-2331
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-723-5533
Provider Business Mailing Address Fax Number:
401-723-3833

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
116 EDDIE DOWLING HWY
Provider Second Line Business Practice Location Address:
REHAB HOSPITAL OF RI
Provider Business Practice Location Address City Name:
N SMITHFIELD
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02896-7327
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-766-0800
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/23/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CHAREST
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
R
Authorized Official Title or Position:
PRESIDENT & CEO
Authorized Official Telephone Number:
401-769-4100

Provider Taxonomy Codes

  • Taxonomy code: 103G00000X , with the licence number:  PS309 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208100000X , with the licence number: MD08700 , 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: 004002 . This is a "BLUE CHIP" identifier . This identifiers is of the category "OTHER".