| Psychiatric Physcian Consultants Of Ri Inc | |
|
345 Blackstone Blvd Providence RI 02906-4800 | |
| (401) 421-0060 | |
| (401) 421-6676 |
| Full Name | Psychiatric Physcian Consultants Of Ri Inc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 345 Blackstone Blvd, Providence, Rhode Island |
| Authorized Official Name and Position | Charles Brandon Qualls (PRESIDENT) |
| Authorized Official Contact | 4014210060 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychiatric Physcian Consultants Of Ri Inc 345 Blackstone Blvd Providence RI 02906-4800 Ph: (401) 421-0060 | Psychiatric Physcian Consultants Of Ri Inc 345 Blackstone Blvd Providence RI 02906-4800 Ph: (401) 421-0060 |
| NPI Number | 1396913406 |
|---|---|
| Provider Enumeration Date | 02/12/2008 |
| Last Update Date | 07/08/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396913406 | NPI | - | NPPES |
| PP15721 | Medicaid | RI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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