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General NPI Number Information
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NPI Number | 1497781827
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Entity Type | Organization
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Legal Business Name | EDWARD J MCDONALD
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Dates
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Enumeration Date | 06/25/2006
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 3466 W SHORE RD
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City | WARWICK
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State | RI
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Zip | 02886-5035
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Country | US
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Telephone | 401-738-6277
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Fax |
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Provider Business Mailing Address
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Address Line | 3466 W SHORE RD
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City | WARWICK
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State | RI
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Zip | 02886-5035
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Country | US
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Telephone | 401-738-6277
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Fax |
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Authorized Official
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Title or Position | OPTICIAN
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Name | MR. EDWARD J MCDONALD
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Credential | R.O.
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Telephone | 401-738-6277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | RO00104
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License Number State | RI
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