Organization
PROSPECT CHARTERCARE SJHSRI, LLC
Active
Organization
PROSPECT CHARTERCARE SJHSRI, LLC
Active
Other names
Our Lady of Fatima Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT JON ELDERS (SECRETARY)
(714) 788-1249
Entity
Organization
Contact information
Practice address
200 HIGH SERVICE AVE, NORTH PROVIDENCE, RI 02904-5113
(401) 456-3000
(401) 456-3028
Mailing address
200 HIGH SERVICE AVE, NORTH PROVIDENCE, RI 02904-5113
(401) 456-3000
(401) 456-3028
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
—
—
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Enumeration date
02/27/2014
Last updated
01/15/2021
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