Organization
PHYSICIANS OF RHODE ISLAND ENTERPRISES INCORPORATED
Active
Other names
PRIME
Organization subpart
No
Provider details
NPI number
Authorized official
DIRENDIA SHACKELFORD (MANAGED CARE SPECIALIST)
(800) 654-0889
Entity
Organization
Contact information
Practice address
10 NATE WHIPPLE HW 101, CUMBERLAND, RI 02864
(401) 658-2020
(401) 658-3612
Mailing address
10 NATE WHIPPLE HW 101, CUMBERLAND, RI 02864
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
MD10232
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4106426
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
7008326
—
RI
Enumeration date
10/24/2006
Last updated
08/22/2020
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