# NORTHWEST COMMUNITY HEALTH CARE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** WellOne Primary Medical and Dental Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801951397
- **Authorized official:** MR. PETER J. BANCROFT CPA (PRESIDENT & CEO)
- **Authorized official phone:** (401) 285-5119

## Contact information

- **Practice address:** 308 CALLAHAN RD, N. KINGSTOWN, RI 02852-7739
- **Practice address phone:** (401) 295-9706
- **Practice address fax:** (401) 295-0920
- **Mailing address:** PO BOX 312, PASCOAG, RI 02859
- **Mailing address phone:** (401) 568-7664
- **Mailing address fax:** (401) 285-5101

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | ACF01530 | RI | — |
| 261QC1500X | Community Health Clinic/Center | ACF01597 | RI | Yes |

## Other

- **Enumeration date:** 12/26/2006
- **Last updated:** 10/21/2011