Healthcare Provider Details

I. General information

NPI: 1114961729
Provider Name (Legal Business Name): ROGER WILLIAMS MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 04/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 MAUDE ST
PROVIDENCE RI
02908-4325
US

IV. Provider business mailing address

50 MAUDE STREET
PROVIDENCE RI
02908
US

V. Phone/Fax

Practice location:
  • Phone: 401-456-2273
  • Fax: 401-456-2514
Mailing address:
  • Phone: 401-456-2273
  • Fax: 401-456-2514

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHNC02226
License Number StateRI

VIII. Authorized Official

Name: MRS. MARCIA WERBER FELDMAN
Title or Position: EXECUTIVE DIRECTOR
Credential: M.S.
Phone: 401-456-2101