| CH Specialty Services Ri LLC | |
|
57 Grandvll Ct Wakefield RI 02879-8242 | |
| (337) 408-0797 | |
| Not Available |
| Full Name | CH Specialty Services Ri LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 57 Grandvll Ct, Wakefield, Rhode Island |
| Authorized Official Name and Position | Nicole Howard (SVP OF ADMINISTRATIVE SERVICES) |
| Authorized Official Contact | 3374080797 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| CH Specialty Services Ri LLC 5750 Johnston St Ste 205 Lafayette LA 70503-5345 Ph: (337) 408-0797 | CH Specialty Services Ri LLC 57 Grandvll Ct Wakefield RI 02879-8242 Ph: (337) 408-0797 |
| NPI Number | 1023807427 |
|---|---|
| Provider Enumeration Date | 05/02/2025 |
| Last Update Date | 05/22/2026 |
| Certification Date | 05/22/2026 |
| Medicare PECOS PAC ID | 2163934092 |
|---|---|
| Medicare Enrollment ID | O20250625002376 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023807427 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Vlastimil Smetka |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497974273 PECOS PAC ID: 1658424825 Enrollment ID: I20250625002251 |
| Provider Name | Ainsly Manning |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1851362537 PECOS PAC ID: 4385627314 Enrollment ID: I20250904003338 |
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