| Codac Healthcare, Llc | |
|
349 Huntington Ave Providence RI 02909-3005 | |
| (401) 942-1450 | |
| (401) 946-1550 |
| Full Name | Codac Healthcare, Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 349 Huntington Ave, Providence, Rhode Island |
| Authorized Official Name and Position | Alisha Bourdeau (CFO) |
| Authorized Official Contact | 4012755038 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Codac Healthcare, Llc 1052 Park Ave Cranston RI 02910-3225 Ph: (401) 275-5038 | Codac Healthcare, Llc 349 Huntington Ave Providence RI 02909-3005 Ph: (401) 942-1450 |
| NPI Number | 1447944111 |
|---|---|
| Provider Enumeration Date | 06/06/2023 |
| Last Update Date | 06/06/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447944111 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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