Organization
LANDMARK MEDICAL CENTER
Active
Organization
LANDMARK MEDICAL CENTER
Active
Other names
Landmark MC Nuclear Med Dept.
Organization subpart
No
Provider details
NPI number
Authorized official
MARY MACINTOSH (SVP/CFO)
(401) 769-4100
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
207U00000X
Nuclear Medicine Physician
00117
RI
207UN0901X
Nuclear Cardiology Physician
Primary
00117
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000006491
BLUE SHIELD/BLUE CHIP
RI
05
—
9006491
—
RI
01
—
903288
TUFTS HEALTH PLAN (OP)
MA
01
—
903289
TUFTS HEALTH PLAN (IP)
MA
Enumeration date
12/29/2005
Last updated
09/11/2025
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