1134197411 NPI number — TOWN OF WEST WARWICK RI

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134197411 NPI number — TOWN OF WEST WARWICK RI

Employer Identification Number (EIN):

Provider Organization Name:

TOWN OF WEST WARWICK RI

Provider Last Name:

Provider First Name:

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

Provider Gender Code:

Provider Other Organization Name:

Provider Other Organization Name Type Code:

6

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:

1134197411

Entity Type Code:

Organization

Replacement NPI:

Last Update Date:

07/16/2019

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 8879

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:

02920-0879

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

401-572-3120

Provider Business Mailing Address Fax Number:

401-572-3351

Provider First Line Business Practice Location Address:

1170 MAIN STREET

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

WEST WARWICK

Provider Business Practice Location Address State Name:

RI

Provider Business Practice Location Address Postal Code:

02893-4829

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

401-822-8241

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

03/10/2006

Authorized Official Last Name:

VARONE

Authorized Official First Name:

J. JEFFREY

Authorized Official Middle Name:

Authorized Official Title or Position:

CHIEF

Authorized Official Telephone Number:

401-822-8241

• Taxonomy code: 3416L0300X , with the licence number:  34 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 341600000X , with the licence number: 34 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 3416L0300X , with the licence number: 0034 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 204771 . This is a "BLUE CHIP" identifier . This identifiers is of the category "OTHER".
• Identifier: 000000026935 . This is a "BMC HEALTHNET PLAN" identifier . This identifiers is of the category "OTHER".
• Identifier: 803242 . This is a "TUFTS HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
• Identifier: 590010995 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 203523000 . This is a "DEPARTMENT OF LABOR" identifier . This identifiers is of the category "OTHER".
• Identifier: 701877 . This is a "HARVARD PILGRIM" identifier . This identifiers is of the category "OTHER".
• Identifier: 9007318 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
• Identifier: 0000007318 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
• Identifier: 0000Z43889 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".