| Wellnorth Medical Llc | |
|
1630 Mineral Spring Ave 2 North Providence RI 02904-4025 | |
| (401) 438-1010 | |
| Not Available |
| Full Name | Wellnorth Medical Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1630 Mineral Spring Ave, North Providence, Rhode Island |
| Authorized Official Name and Position | Javid Calcatti (DIRECTOR) |
| Authorized Official Contact | 4014381010 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellnorth Medical Llc 1630 Mineral Spring Ave 2 North Providence RI 02904-4043 Ph: (401) 438-1010 | Wellnorth Medical Llc 1630 Mineral Spring Ave 2 North Providence RI 02904-4025 Ph: (401) 438-1010 |
| NPI Number | 1568667848 |
|---|---|
| Provider Enumeration Date | 06/18/2007 |
| Last Update Date | 12/16/2015 |
| Medicare PECOS PAC ID | 8628235652 |
|---|---|
| Medicare Enrollment ID | O20120202000859 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568667848 | NPI | - | NPPES |
| CP408256 | Other | RI | BLUE CHIP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Javid A Calcatti |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386722700 PECOS PAC ID: 6507823713 Enrollment ID: I20041220000110 |
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