| The Providence Community Health Centers Inc. | |
|
434 Mount Pleasant Ave Providence RI 02908-3302 | |
| (888) 612-7242 | |
| (401) 444-0421 |
| Full Name | The Providence Community Health Centers Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 434 Mount Pleasant Ave, Providence, Rhode Island |
| Authorized Official Name and Position | Brenda L. 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 |
|---|---|
| The Providence Community Health Centers Inc. 375 Allens Ave Providence RI 02905-5010 Ph: (401) 780-2511 | The Providence Community Health Centers Inc. 434 Mount Pleasant Ave Providence RI 02908-3302 Ph: (888) 612-7242 |
| NPI Number | 1366033532 |
|---|---|
| Provider Enumeration Date | 02/01/2021 |
| Last Update Date | 02/01/2021 |
| Medicare PECOS PAC ID | 9335050962 |
|---|---|
| Medicare Enrollment ID | O20210324003052 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366033532 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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