Organization
NORTHWEST COMMUNITY HEALTH CARE
Active
Organization
NORTHWEST COMMUNITY HEALTH CARE
Active
Other names
WellOne Primary Medical and Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER J. BANCROFT CPA (PRESIDENT & CEO)
(401) 285-5119
Entity
Organization
Contact information
Practice address
308 CALLAHAN RD, N. KINGSTOWN, RI 02852-7739
(401) 295-9706
(401) 295-0920
Mailing address
PO BOX 312, PASCOAG, RI 02859
(401) 568-7664
(401) 285-5101
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
ACF01530
RI
261QC1500X
Community Health Clinic/Center
Primary
ACF01597
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
BS41305
—
RI
05
—
BS41307
—
RI
05
—
NC50602
—
RI
Enumeration date
12/26/2006
Last updated
10/21/2011
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