Organization
PROSPECT CHARTERCARE PHYSICIANS LLC
Active
Other names
CHARTERCARE MEDICAL ASSOC. INFUSION CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT JON ELDERS (SECRETARY)
(714) 788-1249
Entity
Organization
Contact information
Practice address
50 MAUDE ST, PROVIDENCE, RI 02908-4325
(401) 456-2360
Mailing address
825 CHALKSTONE AVE, N. CAMPUS BUSINESS OFFICE, PROVIDENCE, RI 02908-4728
(401) 456-2525
(401) 456-6742
Taxonomy
Speciality
Code
Description
License number
State
261QI0500X
Infusion Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
03/31/2015
Last updated
01/11/2021
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