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Organization

CCSRI, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VERONICA PICKENS (AVP, COMPLIANCE AND DELEGATION)
(301) 809-4000
Entity
Organization

Contact information

Practice address
650 TEN ROD RD, NORTH KINGSTOWN, RI 02852-4238
(301) 809-4000
Mailing address
4321 COLLINGTON RD, BOWIE, MD 20716-2259

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary

Other

Enumeration date
05/18/2018
Last updated
12/10/2019
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