Organization
LANDMARK MEDICAL CENTER
Active
Other names
Landmark MC EKG Dept.
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD CHAREST (PRESIDENT)
(401) 769-4100
Entity
Organization
Contact information
Practice address
115 CASS AVE, WOONSOCKET, RI 02895-4705
(401) 769-4100
(401) 765-6024
Mailing address
196 CASS AVE, WOONSOCKET, RI 02895-4712
(401) 769-4100
(401) 765-6024
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
00117
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000006486
BLUE SHIELD/BLUE CHIP
RI
05
—
9006486
—
RI
01
—
903288
TUFTS HEALTH PLAN (OP)
MA
01
—
903289
TUFTS HEALTH PLAN (IP)
MA
Enumeration date
12/29/2005
Last updated
07/28/2010
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