Organization
PRIME HEALTHCARE SERVICES-LANDMARK LLC
Active
Parent organization
LANDMARK MEDICAL CENTER
Other names
Landmark Medical Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
LANDMARK MEDICAL CENTER
Authorized official
RICHARD CHAREST (PRESIDENT)
(401) 769-4100
Entity
Organization
Contact information
Practice address
115 CASS AVE, WOONSOCKET, RI 02895-4705
(401) 769-4100
(401) 765-6024
Mailing address
196 CASS AVE, WOONSOCKET, RI 02895-4712
(401) 769-4100
(401) 765-6024
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
00117
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000010
BLUE CROSS
RI
01
—
1015600
BEACON HEALTH STRATEGIES
RI
01
—
222921474
TRICARE
RI
05
—
4100011
—
RI
01
—
5012812
UNITED HEALTHCARE
RI
05
—
7000251
—
MA
05
—
7029241
—
MA
01
—
900934
HARVARD PILGRIM HEALTH
MA
01
—
903288
TUFTS HEALTH PLAN (OP)
MD
01
—
903289
TUFTS HEALTH PLAN (IP)
MA
01
—
H00104
BLUE CHIP
RI
05
—
OP00011
—
RI
Enumeration date
12/28/2005
Last updated
02/18/2014
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