Healthcare Provider Details

I. General information

NPI: 1295816247
Provider Name (Legal Business Name): CITY OF EAST PROVIDENCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 02/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 WATERMAN AVE
EAST PROVIDENCE RI
02914-2427
US

IV. Provider business mailing address

PO BOX 20104
CRANSTON RI
02920-0927
US

V. Phone/Fax

Practice location:
  • Phone: 401-435-7800
  • Fax: 401-435-7803
Mailing address:
  • Phone: 401-572-3120
  • Fax: 401-572-3351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number StateRI

VIII. Authorized Official

Name: MR. ROBERT E. ROCK
Title or Position: DIRECTOR
Credential:
Phone: 401-572-3120