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General NPI Number Information
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NPI Number | 1689703860
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Entity Type | Organization
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Legal Business Name | CITY OF EAST PROVIDENCE
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 05/20/2012
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Provider Practice Location Address
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Address Line | 913 BROADWAY
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City | EAST PROVIDENCE
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State | RI
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Zip | 02914-3701
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Country | US
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Telephone | 401-435-7683
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Fax | 401-435-5166
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Provider Business Mailing Address
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Address Line | PO BOX 8879
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City | CRANSTON
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State | RI
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Zip | 02920-0879
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Country | US
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Telephone | 401-572-3120
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Fax | 401-572-3351
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Authorized Official
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Title or Position | EMS DIRECTOR
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Name | JOHN HENRY POTVIN
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Credential |
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Telephone | 401-435-7683
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 13
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License Number State | RI
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