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Organization
PAWTUXET VALLEY MEDICAL, INC.
Active
Organization
PAWTUXET VALLEY MEDICAL, INC.
Active
Other names
Pawtuxet Valley Urgent Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL F. COLLINS M.D. (PRESIDENT)
(401) 821-6800
Entity
Organization
Contact information
Practice address
982 TIOGUE AVE, COVENTRY, RI 02816-6167
(401) 821-6800
(401) 823-9203
Mailing address
982 TIOGUE AVE, COVENTRY, RI 02816-6167
(401) 821-6800
(401) 823-9203
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208D00000X
General Practice Physician
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000655
BLUE CROSS
RI
01
—
001738
BLUE CHIP
RI
01
—
2661
NEIGHBORHOOD HEALTH
RI
01
—
66-00112
UNITED HEALTHCARE
RI
05
—
9000655
—
RI
Enumeration date
07/14/2006
Last updated
03/10/2011
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