Organization
PRIME HEALTHCARE SERVICES LANDMARK LLC
Active
Parent organization
PRIME HEALTHCARE SERVICES LANDMARK LLC
Other names
Landmark Health 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
207RH0003X
Hematology & Oncology Physician
Primary
—
—
2084P0800X
Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
208600000X
Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PR95788
—
RI
Enumeration date
12/16/2013
Last updated
01/11/2017
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