Organization
PRIME HEALTHCARE SERVICES LANDMARK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE BRENMAN (PRACTICE ADMINISTRATOR)
(401) 769-4100
Entity
Organization
Contact information
Practice address
219 CASS AVE, WOONSOCKET, RI 02895-4736
(401) 769-4100
(401) 766-9575
Mailing address
219 CASS AVE, WOONSOCKET, RI 02895-4736
(401) 769-4100
(401) 766-9575
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2084P0800X
Psychiatry Physician
—
—
208600000X
Surgery Physician
—
—
2086X0206X
Surgical Oncology Physician
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9005058
—
RI
Enumeration date
11/22/2013
Last updated
11/22/2013
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