| Thundermist Health Center | |
|
25 John A Cummings Way Woonsocket RI 02895-3244 | |
| (401) 767-4161 | |
| (401) 767-5441 |
| Full Name | Thundermist Health Center |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 25 John A Cummings Way, Woonsocket, Rhode Island |
| Authorized Official Name and Position | Ckarla Agudelo (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 4017674100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thundermist Health Center 171 Service Ave Ste 330 Warwick RI 02886-1015 Ph: (401) 767-4100 | Thundermist Health Center 25 John A Cummings Way Woonsocket RI 02895-3244 Ph: (401) 767-4161 |
| NPI Number | 1457522989 |
|---|---|
| Provider Enumeration Date | 03/12/2008 |
| Last Update Date | 09/19/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457522989 | NPI | - | NPPES |
| TH02580 | Medicaid | RI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | ACF01569 (Rhode Island) | Primary |
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