Organization
PROSPECT BLACKSTONE VALLEY SURGICARE, LLC
Active
Other names
Blackstone Valley Surgicare
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT ELDERS JD (SECRETARY)
(310) 943-4500
Entity
Organization
Contact information
Practice address
1526 ATWOOD AVE, SUITE 300, JOHNSTON, RI 02919-3289
(401) 459-3800
Mailing address
1526 ATWOOD AVE, SUITE 300, JOHNSTON, RI 02919-3289
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
01/31/2017
Last updated
01/15/2021
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