Healthcare Provider Details

I. General information

NPI: 1891017067
Provider Name (Legal Business Name): MEMORIAL HOSPITAL OF RI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2010
Last Update Date: 02/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 PROSPECT ST APT. 25
PAWTUCKET RI
02860-5462
US

IV. Provider business mailing address

329 PROSPECT ST APT. 25
PAWTUCKET RI
02860-5462
US

V. Phone/Fax

Practice location:
  • Phone: 401-808-5991
  • Fax:
Mailing address:
  • Phone: 401-808-5991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License NumberLP0129
License Number StateRI

VIII. Authorized Official

Name: MARTIN TURSKY
Title or Position: BACHELOR OF SCIENCE DEGREE IN ENG.
Credential:
Phone: 401-729-2000