1437157898 NPI number — SCALABRINI VILLA, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437157898 NPI number — SCALABRINI VILLA, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SCALABRINI VILLA, INC.
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:
1437157898
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/03/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
860 N QUIDNESSETT RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH KINGSTOWN
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02852-1000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-884-1802
Provider Business Mailing Address Fax Number:
401-884-4727

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
860 N QUIDNESSETT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH KINGSTOWN
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02852-1000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-884-1802
Provider Business Practice Location Address Fax Number:
401-884-4727
Provider Enumeration Date:
07/11/2005

Additional Information

Authorized Official

Authorized Official Last Name:
RYAN
Authorized Official First Name:
JOY
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
401-884-1802

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  LTC00367 , 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: 5003 . This is a "BLUE CROSS & BLUE SHIELD" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 4105063 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 71-07104 . This is a "UNITED HEALTHCARE OF NE" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 40-2433 . This is a "BLUE CHIP OF RI" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 71-01149 . This is a "UNITED HEALTH - EVERCARE" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".




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