# ST JOSEPH HEALTH SERVICES OF RHODE ISLAND

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114186715
- **Authorized official:** MR. JOHN FOGERTY (PRESIDENT - CEO)
- **Authorized official phone:** (401) 456-3309

## Contact information

- **Practice address:** 21 PEACE ST, PROVIDENCE, RI 02907-1510
- **Practice address phone:** (401) 456-3309
- **Practice address fax:** (401) 456-3762
- **Mailing address:** 200 HIGH SERVICE AVE, 4TH FL MARION HALL, NORTH PROVIDENCE, RI 02904-5113
- **Mailing address phone:** (401) 456-3309
- **Mailing address fax:** (401) 456-3762

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133N00000X | Nutritionist | HOS00110 | RI | — |
| 171R00000X | Interpreter | HOS00110 | RI | — |
| 207Q00000X | Family Medicine Physician | HOS00110 | RI | Yes |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | HOS001100 | RI | — |
| 207V00000X | Obstetrics & Gynecology Physician | HOS00110 | RI | — |

## Other

- **Enumeration date:** 06/09/2008
- **Last updated:** 06/09/2008