The Providence Community Health Centers, Inc | |
145 Beaufort St Providence RI 02908-3929 | |
(888) 612-7242 | |
(401) 444-0421 |
Full Name | The Providence Community Health Centers, Inc |
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Speciality | Clinic/Center |
Location | 145 Beaufort St, Providence, Rhode Island |
Authorized Official Name and Position | Brenda Charpentier (CREDENTIALING SPECIALIST) |
Authorized Official Contact | 4017802511 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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The Providence Community Health Centers, Inc 375 Allens Ave Providence RI 02905-5010 Ph: (401) 780-2511 | The Providence Community Health Centers, Inc 145 Beaufort St Providence RI 02908-3929 Ph: (888) 612-7242 |
NPI Number | 1013628965 |
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Provider Enumeration Date | 12/12/2022 |
Last Update Date | 12/12/2022 |
Medicare PECOS PAC ID | 9335050962 |
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Medicare Enrollment ID | O20230302002024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013628965 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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