| Prime Healthcare Services-landmark Llc | |
|
115 Cass Ave Woonsocket RI 02895-4705 | |
| (401) 769-4100 | |
| (401) 765-6024 |
| Full Name | Prime Healthcare Services-landmark Llc |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 115 Cass Ave, Woonsocket, Rhode Island |
| Authorized Official Name and Position | Richard Charest (PRESIDENT) |
| Authorized Official Contact | 4017694100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Healthcare Services-landmark Llc 196 Cass Ave Woonsocket RI 02895-4712 Ph: (401) 769-4100 | Prime Healthcare Services-landmark Llc 115 Cass Ave Woonsocket RI 02895-4705 Ph: (401) 769-4100 |
| NPI Number | 1396722666 |
|---|---|
| Provider Enumeration Date | 12/28/2005 |
| Last Update Date | 02/18/2014 |
| Medicare PECOS PAC ID | 3274761069 |
|---|---|
| Medicare Enrollment ID | O20140131000196 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396722666 | NPI | - | NPPES |
| 7000251 | Medicaid | MA | |
| 900934 | Other | MA | HARVARD PILGRIM HEALTH |
| 0000000010 | Other | RI | BLUE CROSS |
| 1015600 | Other | RI | BEACON HEALTH STRATEGIES |
| 4100011 | Medicaid | RI | |
| 903289 | Other | MA | TUFTS HEALTH PLAN (IP) |
| H00104 | Other | RI | BLUE CHIP |
| 5012812 | Other | RI | UNITED HEALTHCARE |
| 903288 | Other | MD | TUFTS HEALTH PLAN (OP) |
| 222921474 | Other | RI | TRICARE |
| 7029241 | Medicaid | MA | |
| OP00011 | Medicaid | RI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 00117 (Rhode Island) | Primary |
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