Organization
STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS
Active
Organization
STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS
Active
Other names
Department of Health
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS A AXELSEN (CFO)
(401) 222-5112
Entity
Organization
Contact information
Practice address
3 CAPITOL HL, ROOM 402, PROVIDENCE, RI 02908-5034
(401) 222-5112
(401) 222-1256
Mailing address
3 CAPITOL HL, ROOM 402, PROVIDENCE, RI 02908-5034
(401) 222-5112
(401) 222-1256
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000031189
BLUE CROSS PROVIDER NUMBR
RI
Enumeration date
03/15/2007
Last updated
10/17/2011
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