Organization
LANDMARK MEDICAL CENTER
Active
Other names
Landmark MC Occupational Medicine Dept. NP
Organization subpart
No
Provider details
NPI number
Authorized official
MARY MACINTOSH (SVP/CFO)
(401) 769-4100
Entity
Organization
Contact information
Practice address
115 CASS AVE, WOONSOCKET, RI 02895-4705
(401) 769-4100
(401) 769-1744
Mailing address
196 CASS AVE, WOONSOCKET, RI 02895-4712
(401) 769-4100
(401) 765-6024
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
00117
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000028083
BEACON/BLUE SHIELD (NP)
RI
Enumeration date
12/29/2005
Last updated
08/22/2020
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