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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