Organization
PRIME HEALTHCARE SERVICES LANDMARK LLC
Active
Parent organization
PRIME HEALTHCARE SERVICES LANDMARK LLC
Other names
Landmark Physician Office Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRIME HEALTHCARE SERVICES LANDMARK LLC
Authorized official
MS. STACY VIENS (PRACTICE ADMINISTRATOR)
(401) 769-4100
Entity
Organization
Contact information
Practice address
219 CASS AVE, WOONSOCKET, RI 02895-4736
(401) 769-4100
(401) 766-9575
Mailing address
219 CASS AVE, WOONSOCKET, RI 02895-4736
(401) 769-4100
(401) 766-9575
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
208600000X
Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
2086X0206X
Surgical Oncology Physician
—
—
213E00000X
Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
363AS0400X
Surgical Physician Assistant
—
—
367A00000X
Advanced Practice Midwife
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PR95770
—
RI
Enumeration date
12/17/2013
Last updated
01/20/2023
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