Organization
PAWTUXET VALLEY MEDICAL, INC.
Active
Other names
Pawtuxet Valley Urgent Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL F. COLLINS M.D. (PRESIDENT)
(401) 821-6800
Entity
Organization
Contact information
Practice address
982 TIOGUE AVE, COVENTRY, RI 02816-6167
(401) 821-6800
(401) 823-9203
Mailing address
982 TIOGUE AVE, COVENTRY, RI 02816-6167
(401) 821-6800
(401) 823-9203
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208D00000X
General Practice Physician
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000655
BLUE CROSS
RI
01
—
001738
BLUE CHIP
RI
01
—
2661
NEIGHBORHOOD HEALTH
RI
01
—
66-00112
UNITED HEALTHCARE
RI
05
—
9000655
—
RI
Enumeration date
07/14/2006
Last updated
03/10/2011
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