1386643294 NPI number — KENT COUNTY MEMORIAL HOSPITAL

Table of content: (NPI 1386643294)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386643294 NPI number — KENT COUNTY MEMORIAL HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KENT COUNTY MEMORIAL 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:
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:
1386643294
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/29/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
455 TOLL GATE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WARWICK
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02886-2759
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-737-7010
Provider Business Mailing Address Fax Number:
401-736-1000

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
455 TOLL GATE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WARWICK
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02886-2759
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-737-7010
Provider Business Practice Location Address Fax Number:
401-736-1000
Provider Enumeration Date:
07/21/2005

Additional Information

Authorized Official

Authorized Official Last Name:
BURKE
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
MICHAEL
Authorized Official Title or Position:
VP OF FINANCE
Authorized Official Telephone Number:
401-737-7010

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RP1001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZP0105X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084N0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2086S0129X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282N00000X , with the licence number: HOS00125 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 324500000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 0000006181 . This is a "KENT COUNTY PHYS PATH" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 000000001935 . This is a "KENT COUNTY MEMORIAL HOSP" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 0000000021 . This is a "KENT COUNTY MEMORIAL HOSP" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 0000006111 . This is a "KENT COUNTY PHYS EKG" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 0000006112 . This is a "KENT COUNTY PHYS PULM" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 5000154 . This is a "KENT COUNTY MEMORIAL HOSP" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: OP00009 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4100009 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5000152 . This is a "KENT COUNTY MEMORIAL HOSP" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 709006109 . This is a "KENT COUNTY PHYS VASC" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 900247 . This is a "KENT COUNTY MEMORIAL HOSP" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 0000006109 . This is a "KENT COUNTY PHYS VASC" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 0000006110 . This is a "KENT COUNTY PHYS EEG" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: DD3248 . This is a "KENT COUNTY HOSPITAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 112478400 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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