Healthcare Provider Details

I. General information

NPI: 1699811059
Provider Name (Legal Business Name): RHODE ISLAND BLOOD CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 10/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 PROMENADE STREET
PROVIDENCE RI
02908-4811
US

IV. Provider business mailing address

405 PROMENADE STREET
PROVIDENCE RI
02908-4811
US

V. Phone/Fax

Practice location:
  • Phone: 401-453-2393
  • Fax: 401-248-5750
Mailing address:
  • Phone: 401-453-2393
  • Fax: 401-248-5750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License NumberMD08912
License Number StateRI

VIII. Authorized Official

Name: DR. CAROLYN T YOUNG
Title or Position: V.P. AND CHEIF MEDICAL OFFICER
Credential: M.D.
Phone: 401-453-4392