Organization
PRIME HEALTHCARE SERVICES LANDMARK LLC
Active
Other names
Landmark Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER DOAN (MANAGING ASSOCIATE GENERAL COUNSEL)
(310) 259-4706
Entity
Organization
Contact information
Practice address
115 CASS AVE, WOONSOCKET, RI 02895-4705
(401) 769-4100
(401) 769-1744
Mailing address
196 CASS AVE, WOONSOCKET, RI 02895-4712
(401) 769-4100
(401) 765-6024
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
00117
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000010
BLUE CROSS
RI
01
—
000000001930
NEIGHBORHOOD HEALTH PLAN
RI
01
—
222921474
TRICARE
RI
05
—
4100011
—
RI
01
—
5000704
UNITED HEALTHCARE
RI
05
—
7000251
—
MA
05
—
7029241
—
MA
01
—
900934
HARVARD PILGRIM HEALTH
MA
01
—
903288
TUFTS HEALTH PLAN OUTPT
MA
01
—
903289
TUFTS HEALTH PLAN INPAT.
MA
01
—
H00104
BLUE CHIP
RI
05
—
OP00011
—
RI
Enumeration date
12/28/2005
Last updated
06/14/2022
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