# PRIME HEALTHCARE SERVICES LANDMARK LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PRIME HEALTHCARE SERVICES LANDMARK LLC
- **Other names:** Landmark Physician Office Services
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1457772543
- **Legal business name:** PRIME HEALTHCARE SERVICES LANDMARK LLC
- **Authorized official:** MS. STACY VIENS (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (401) 769-4100

## Contact information

- **Practice address:** 219 CASS AVE, WOONSOCKET, RI 02895-4736
- **Practice address phone:** (401) 769-4100
- **Practice address fax:** (401) 766-9575
- **Mailing address:** 219 CASS AVE, WOONSOCKET, RI 02895-4736
- **Mailing address phone:** (401) 769-4100
- **Mailing address fax:** (401) 766-9575

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RP1001X | Pulmonary Disease Physician | — | NULL | — |
| 207RP1001X | Pulmonary Disease Physician | — | — | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | — |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 2086S0129X | Vascular Surgery Physician | — | NULL | — |
| 2086S0129X | Vascular Surgery Physician | — | — | — |
| 2086X0206X | Surgical Oncology Physician | — | NULL | — |
| 2086X0206X | Surgical Oncology Physician | — | — | — |
| 213E00000X | Podiatrist | — | NULL | — |
| 213E00000X | Podiatrist | — | — | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | — |
| 363AS0400X | Surgical Physician Assistant | — | NULL | — |
| 363AS0400X | Surgical Physician Assistant | — | — | — |
| 367A00000X | Advanced Practice Midwife | — | NULL | — |
| 367A00000X | Advanced Practice Midwife | — | — | — |

## Other

- **Enumeration date:** 12/17/2013
- **Last updated:** 01/20/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | PR95770 | — | RI |