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General NPI Number Information
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NPI Number | 1669726451
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Entity Type | Organization
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Legal Business Name | THE MIRIAM HOSPITAL
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Dates
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Enumeration Date | 11/01/2012
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 164 SUMMIT AVE 2RD FLOOR FAIN BUILDING
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City | PROVIDENCE
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State | RI
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Zip | 02906-2853
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Country | US
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Telephone | 401-793-2919
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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 | 401-444-5640
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Fax |
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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 | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | HOS00122
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License Number State | RI
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