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Organization

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Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS PATRICIA A NICHOLS (OWNER)
(401) 921-1810
Entity
Organization

Contact information

Practice address
17A DEWEY AVE, WARWICK, RI 02886-2431
(401) 921-1810
(401) 921-1816
Mailing address
17A DEWEY AVE, WARWICK, RI 02886-2431
(401) 921-1810
(401) 921-1816

Taxonomy

Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
96772
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2320001
RI
Enumeration date
03/30/2007
Last updated
06/13/2008
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