Healthcare Provider Details

I. General information

NPI: 1780626556
Provider Name (Legal Business Name): ELEANOR SLATER HOSPITAL ZAMBARANO UNIT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 08/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2090 WALLUM LAKE RD
PASCOAG RI
02859-1813
US

IV. Provider business mailing address

2090 WALLUM LAKE RD
PASCOAG RI
02859-1813
US

V. Phone/Fax

Practice location:
  • Phone: 401-462-3077
  • Fax: 401-462-0974
Mailing address:
  • Phone: 401-462-3077
  • Fax: 401-462-0974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberPHB00018
License Number StateRI

VIII. Authorized Official

Name: CATHY HOPKINS
Title or Position: ADMINISTRATOR PHARMACY SVCS
Credential: RPH
Phone: 401-462-3077