Healthcare Provider Details

I. General information

NPI: 1154461663
Provider Name (Legal Business Name): CITY OF CRANSTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 11/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 PONTIAC AVE
CRANSTON RI
02910-2032
US

IV. Provider business mailing address

PO BOX 8879
CRANSTON RI
02920-0879
US

V. Phone/Fax

Practice location:
  • Phone: 401-760-4021
  • Fax:
Mailing address:
  • Phone: 401-572-3120
  • Fax: 401-572-3351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number11
License Number StateRI

VIII. Authorized Official

Name: PAUL A CASEY JR.
Title or Position: DEPUTY CHIEF
Credential:
Phone: 401-760-4021