| Lotus Noire Health | |
|
460 Smithfield Ave Pawtucket RI 02860-2576 | |
| (401) 305-0080 | |
| (866) 655-0696 |
| Full Name | Lotus Noire Health |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 460 Smithfield Ave, Pawtucket, Rhode Island |
| Authorized Official Name and Position | Temperance Taylor (OWNER) |
| Authorized Official Contact | 4013050080 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lotus Noire Health 400 Warren Ave Ste 2l-a East Providence RI 02914-3826 Ph: (401) 305-0080 | Lotus Noire Health 460 Smithfield Ave Pawtucket RI 02860-2576 Ph: (401) 305-0080 |
| NPI Number | 1164040069 |
|---|---|
| Provider Enumeration Date | 07/08/2020 |
| Last Update Date | 07/22/2024 |
| Certification Date | 11/01/2023 |
| Medicare PECOS PAC ID | 0244645620 |
|---|---|
| Medicare Enrollment ID | O20210217000570 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164040069 | NPI | - | NPPES |
| 1164040069 | Medicaid | RI |
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