1720014442 NPI number — MEETING STREET CENTER

Table of content: (NPI 1720014442)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720014442 NPI number — MEETING STREET CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEETING STREET CENTER
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:
1720014442
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/15/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1000 EDDY STREET
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
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-533-9100
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 EDDY STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PROVIDENCE
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-533-9100
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MALONE
Authorized Official First Name:
LYNNE
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF FINANCE
Authorized Official Telephone Number:
401-533-9100

Provider Taxonomy Codes

  • Taxonomy code: 252Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QM1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM3000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 2092 . This is a "EI NHPRC NUMBER" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 9009994 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: ES01788 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4600103 . This is a "SL UHP NUMBER" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 6400144 . This is a "PT/OT UHP NUMBER" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: MS59102 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 292177 . This is a "EI BLUE CROSS NUMBER" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 2058 . This is a "SS NHPRC NUMBER" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 412296 . This is a "EI BCHIP NUMBER" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 99947 . This is a "SS BLUE CROSS" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".




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