| Wellone Primary Medical And Dental Care | |
|
36 Bridge Way Pascoag RI 02859 | |
| (401) 567-0800 | |
| (401) 567-0900 |
| Full Name | Wellone Primary Medical And Dental Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 36 Bridge Way, Pascoag, Rhode Island |
| Authorized Official Name and Position | Diane Hopper (VP OF FINANCE) |
| Authorized Official Contact | 4015687664 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellone Primary Medical And Dental Care Po Box 312 Pascoag RI 02859 Ph: (401) 567-0800 | Wellone Primary Medical And Dental Care 36 Bridge Way Pascoag RI 02859 Ph: (401) 567-0800 |
| NPI Number | 1245219070 |
|---|---|
| Provider Enumeration Date | 01/11/2006 |
| Last Update Date | 06/01/2012 |
| Medicare PECOS PAC ID | 1355250663 |
|---|---|
| Medicare Enrollment ID | O20030312000015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245219070 | NPI | - | NPPES |
| NC50602 | Medicaid | RI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | ACF01571 (Rhode Island) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | ACF01571 (Rhode Island) | Primary |
Bayberry Commons Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 181 Davis Dr, Pascoag, RI 02859 Phone: 401-568-0600 Fax: 401-568-3080 | |
Pine Grove Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 999 S. Main Street, Pascoag, RI 02859 Phone: 401-568-3091 Fax: 401-568-8070 | |
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