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
104100000X
Social Worker
—
—
207N00000X
Dermatology Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207T00000X
Neurological Surgery Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
—
—
2084N0400X
Neurology Physician
—
—
2084P0800X
Psychiatry Physician
—
—
208600000X
Surgery Physician
—
—
213E00000X
Podiatrist
—
—
225400000X
Rehabilitation Practitioner
—
—
251K00000X
Public Health or Welfare Agency
—
—
Other
Enumeration date
02/25/2014
Last updated
12/21/2020
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