Organization
ST JOSEPH HEALTH SERVICES OF RHODE ISLAND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN FOGERTY (PRESIDENT - CEO)
(401) 456-3309
Entity
Organization
Contact information
Practice address
21 PEACE ST, PROVIDENCE, RI 02907-1510
(401) 456-3309
(401) 456-3762
Mailing address
200 HIGH SERVICE AVE, 4TH FL MARION HALL, NORTH PROVIDENCE, RI 02904-5113
(401) 456-3309
(401) 456-3762
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
HOS00110
RI
171R00000X
Interpreter
HOS00110
RI
207Q00000X
Family Medicine Physician
Primary
HOS00110
RI
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
HOS001100
RI
207V00000X
Obstetrics & Gynecology Physician
HOS00110
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2127
PROGROUP (NHP)
RI
Enumeration date
06/09/2008
Last updated
06/09/2008
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