Healthcare Provider Details
I. General information
NPI: 1225242381
Provider Name (Legal Business Name): ARA-RHODE ISLAND DIALYSIS II LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/09/2007
Last Update Date: 03/10/2020
Certification Date: 03/10/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2100 DIAMOND HILL RD
WOONSOCKET RI
02895-1544
US
IV. Provider business mailing address
2100 DIAMOND HILL RD
WOONSOCKET RI
02895-1544
US
V. Phone/Fax
- Phone: 401-765-4995
- Fax: 401-769-8315
- Phone: 401-765-4995
- Fax: 401-769-8315
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
SHARI
COUSINS
Title or Position: SR. VP OF CLINICAL & REGULATORY
Credential:
Phone: 978-922-3080