Healthcare Provider Details

I. General information

NPI: 1427079367
Provider Name (Legal Business Name): GREGORY CHARLES HITCHCOCK EMTC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 MISHNOCK RD
WEST GREENWICH RI
02817-1669
US

IV. Provider business mailing address

166 MISHNOCK RD
WEST GREENWICH RI
02817-1669
US

V. Phone/Fax

Practice location:
  • Phone: 401-397-7353
  • Fax: 401-397-9030
Mailing address:
  • Phone: 401-397-7353
  • Fax: 401-397-9030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number12054
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: