Healthcare Provider Details

I. General information

NPI: 1023246378
Provider Name (Legal Business Name): ER CARD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2009
Last Update Date: 07/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1370 MAIN ST
WEST WARWICK RI
02893-3815
US

IV. Provider business mailing address

1370 MAIN ST
WEST WARWICK RI
02893-3815
US

V. Phone/Fax

Practice location:
  • Phone: 401-822-1181
  • Fax: 401-822-3313
Mailing address:
  • Phone: 401-822-1181
  • Fax: 401-822-3313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. MARIA GIL
Title or Position: PARTNER
Credential:
Phone: 401-822-1181