# GLENN S. PRESCOD, M.D., M.P.H., INC.

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

## Provider details

- **NPI number:** 1114271053
- **Authorized official:** DR. GLENN S. PRESCOD M.D. (OWNER)
- **Authorized official phone:** (401) 725-3600

## Contact information

- **Practice address:** 333 SCHOOL ST, SUITE 301, PAWTUCKET, RI 02860-5334
- **Practice address phone:** (401) 725-3600
- **Practice address fax:** (401) 728-8760
- **Mailing address:** 333 SCHOOL ST, SUITE 301, PAWTUCKET, RI 02860-5334
- **Mailing address phone:** (401) 725-3600
- **Mailing address fax:** (401) 728-8760

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 207W00000X | Ophthalmology Physician | 08767 | RI | Yes |

## Other

- **Enumeration date:** 10/30/2012
- **Last updated:** 12/12/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 9020656 | — | RI |