Organization
ST. JOSEPH HEALTH SERVICES OF RI
Active
Other names
WOUND CARE GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL E CONKLIN JR. CFO (SNR. VICE PRESIDENT)
(401) 456-3000
Entity
Organization
Contact information
Practice address
200 HIGH SERVICE AVE, NORTH PROVIDENCE, RI 02904-5113
(401) 456-3000
(401) 752-8248
Mailing address
825 CHALKSTONE AVE, N. CAMPUS BUSINESS OFFICE, ATTN: R. SOARES, PROVIDENCE, RI 02908-4728
(401) 456-2525
(401) 456-6742
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
HOS00110
RI
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
HOS00110
RI
213E00000X
Podiatrist
HOS00110
RI
282N00000X
General Acute Care Hospital
Primary
HOS00110
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SJ48636
—
RI
Enumeration date
02/20/2007
Last updated
12/18/2013
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