Organization
EMERGENCY MEDICINE PHYSICIANS OF PROVIDENCE COUNTY, LLC
Active
Organization
EMERGENCY MEDICINE PHYSICIANS OF PROVIDENCE COUNTY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID C PACKO MD (PRESIDENT)
(330) 493-4443
Entity
Organization
Contact information
Practice address
825 CHALKSTONE AVE, PROVIDENCE, RI 02908-4728
(330) 493-4443
(330) 493-8677
Mailing address
4535 DRESSLER RD NW, CANTON, OH 44718-2545
(330) 493-4443
(330) 493-8677
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9003126
—
RI
Enumeration date
06/06/2006
Last updated
10/23/2007
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