| Pai Participant 5 Pc | |
|
10 Woodland Dr Coventry RI 02816-6716 | |
| (859) 291-4800 | |
| (833) 694-1507 |
| Full Name | Pai Participant 5 Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 10 Woodland Dr, Coventry, Rhode Island |
| Authorized Official Name and Position | Erin N Laird (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 4104588713 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pai Participant 5 Pc Po Box 639676 Cincinnati OH 45263-9676 Ph: (859) 291-4800 | Pai Participant 5 Pc 10 Woodland Dr Coventry RI 02816-6716 Ph: (859) 291-4800 |
| NPI Number | 1194381947 |
|---|---|
| Provider Enumeration Date | 05/17/2019 |
| Last Update Date | 12/22/2025 |
| Medicare PECOS PAC ID | 8325372881 |
|---|---|
| Medicare Enrollment ID | O20190703000887 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194381947 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| Provider Name | Gary B Bernett |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1548204985 PECOS PAC ID: 4486559341 Enrollment ID: I20031204000023 |
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