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General NPI Number Information
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NPI Number | 1225017486
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Entity Type | Organization
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Legal Business Name | EMMA PENDLETON BRADLEY HOSPITAL
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Dates
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Enumeration Date | 01/16/2006
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 1011 VETERANS MEMORIAL PKWY
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City | EAST PROVIDENCE
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State | RI
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Zip | 02915-5061
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Country | US
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Telephone | 401-432-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 15 LA SALLE SQ
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City | PROVIDENCE
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State | RI
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Zip | 02903-1814
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Country | US
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Telephone | 401-444-6779
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Fax | 401-444-6912
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Authorized Official
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Title or Position | EVP & CFO
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Name | PETER K MARKELL
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Credential |
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Telephone | 401-444-7914
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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License Number State | RI
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