Organization
BLACKSTONE MEDICAL CENTER, INC.
Active
Parent organization
STEWARD MEDICAL HOLDINGS, LLC
Other names
Blackstone Medical Center Spine Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
STEWARD MEDICAL HOLDINGS, LLC
Authorized official
MR. JAMES RENNA (CFO)
(617) 419-4772
Entity
Organization
Contact information
Practice address
219 CASS AVENUE, WOONSOCKET, RI 02895-4741
(401) 769-4100
(401) 766-9575
Mailing address
PO BOX 845582, BOSTON, MA 02284-5582
(401) 769-4100
(401) 766-9575
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
00117
RI
207X00000X
Orthopaedic Surgery Physician
Primary
00117
RI
208600000X
Surgery Physician
00117
RI
2086X0206X
Surgical Oncology Physician
00117
RI
Other
Enumeration date
07/13/2012
Last updated
08/01/2012
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