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999 S. Main Street Pascoag RI 02859 | |
(401) 568-3091 | |
(401) 568-8070 |
Full Name | |
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Speciality | Clinic/center |
Location | 999 S. Main Street, Pascoag, Rhode Island |
Authorized Official Name and Position | Peter J Bancroft (CFO) |
Authorized Official Contact | 4012855119 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 312 Pascoag RI 02859 Ph: (401) 567-0800 | 999 S. Main Street Pascoag RI 02859 Ph: (401) 568-3091 |
NPI Number | 1487923793 |
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Provider Enumeration Date | 12/16/2011 |
Last Update Date | 12/16/2011 |
Identifier | Type | State | Issuer |
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1487923793 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |