| Thundermist Health Center | |
|
186 Providence St West Warwick RI 02893-2508 | |
| (401) 615-2800 | |
| (401) 615-2805 |
| Full Name | Thundermist Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 186 Providence St, West Warwick, Rhode Island |
| Authorized Official Name and Position | Ckarla Agudelo (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 4017674100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thundermist Health Center 171 Service Ave Ste 330 Warwick RI 02886-1015 Ph: (401) 767-4100 | Thundermist Health Center 186 Providence St West Warwick RI 02893-2508 Ph: (401) 615-2800 |
| NPI Number | 1376708560 |
|---|---|
| Provider Enumeration Date | 07/28/2008 |
| Last Update Date | 09/19/2018 |
| Medicare PECOS PAC ID | 1557270477 |
|---|---|
| Medicare Enrollment ID | O20030415000024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376708560 | NPI | - | NPPES |
| 4101805 | Medicaid | RI |
| Provider Name | Caroline C Kinney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871006056 PECOS PAC ID: 9436412046 Enrollment ID: I20180412002767 |
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