Blackstone Valley Center For Internal Medicine, Inc | |
191 Social St Suite 840 Woonsocket RI 02895-3240 | |
(401) 762-2535 | |
(401) 762-2858 |
Full Name | Blackstone Valley Center For Internal Medicine, Inc |
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Speciality | Clinic/Center |
Location | 191 Social St, Woonsocket, Rhode Island |
Authorized Official Name and Position | Greigstone Montgomery Yearwood (PRESIDENT/PHYSICIAN) |
Authorized Official Contact | 4017622535 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Blackstone Valley Center For Internal Medicine, Inc 191 Social St Suite 840 Woonsocket RI 02895-3240 Ph: (401) 762-2535 | Blackstone Valley Center For Internal Medicine, Inc 191 Social St Suite 840 Woonsocket RI 02895-3240 Ph: (401) 762-2535 |
NPI Number | 1659338655 |
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Provider Enumeration Date | 04/26/2006 |
Last Update Date | 08/01/2007 |
Medicare PECOS PAC ID | 5698861482 |
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Medicare Enrollment ID | O20071009000730 |
Identifier | Type | State | Issuer |
---|---|---|---|
1659338655 | NPI | - | NPPES |
9020093 | Medicaid | RI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Greigstone M Yearwood |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1689631640 PECOS PAC ID: 9032205828 Enrollment ID: I20101207000878 |
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