Organization
VA MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CRAIG POLUCHA (HUMAN RESOURCES OFFICER)
(401) 273-7100
Entity
Organization
Contact information
Practice address
830 CHALKSTONE AVE, PROVIDENCE, RI 02908-4734
(401) 273-7100
Mailing address
21 PRISCILLA DR, CRANSTON, RI 02921-1517
(401) 862-3140
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
RN33934
RI
Other
Enumeration date
04/09/2006
Last updated
08/22/2020
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