Organization
PROSPECT CHARTERCARE RWMC, LLC
Active
Organization
PROSPECT CHARTERCARE RWMC, LLC
Active
Other names
Roger Williams Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT JON ELDERS (SECRETARY)
(714) 788-1249
Entity
Organization
Contact information
Practice address
825 CHALKSTONE AVE, PROVIDENCE, RI 02908-4728
(401) 456-2000
(401) 456-2029
Mailing address
825 CHALKSTONE AVE, PROVIDENCE, RI 02908-4728
(401) 456-2000
(401) 456-2029
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Enumeration date
02/25/2014
Last updated
01/11/2021
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