# ST. JOSEPH HEALTH SERVICES OF RI

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- **Entity:** Organization
- **Status:** Active
- **Other names:** WOUND CARE GROUP
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013052976
- **Authorized official:** MICHAEL E CONKLIN JR. CFO (SNR. VICE PRESIDENT)
- **Authorized official phone:** (401) 456-3000

## Contact information

- **Practice address:** 200 HIGH SERVICE AVE, NORTH PROVIDENCE, RI 02904-5113
- **Practice address phone:** (401) 456-3000
- **Practice address fax:** (401) 752-8248
- **Mailing address:** 825 CHALKSTONE AVE, N. CAMPUS BUSINESS OFFICE, ATTN: R. SOARES, PROVIDENCE, RI 02908-4728
- **Mailing address phone:** (401) 456-2525
- **Mailing address fax:** (401) 456-6742

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207N00000X | Dermatology Physician | HOS00110 | RI | — |
| 2083P0011X | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician | HOS00110 | RI | — |
| 213E00000X | Podiatrist | HOS00110 | RI | — |
| 282N00000X | General Acute Care Hospital | HOS00110 | RI | Yes |

## Other

- **Enumeration date:** 02/20/2007
- **Last updated:** 12/18/2013