Organization
NORTHWEST COMMUNITY HEALTH CARE
Active
Other names
WellOne Primary Medical and Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE HOPPER CFO (VP OF FINANCE)
(401) 568-7664
Entity
Organization
Contact information
Practice address
36 BRIDGE WAY, PASCOAG, RI 02859
(401) 567-0800
(401) 567-0900
Mailing address
PO BOX 312, PASCOAG, RI 02859
(401) 567-0800
(401) 567-0900
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
ACF01571
RI
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
ACF01571
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NC50602
—
RI
Enumeration date
01/11/2006
Last updated
06/01/2012
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