Provider Demographics
NPI:1215914015
Name:VITAL CARE OF RHODE ISLAND, INC.
Entity type:Organization
Organization Name:VITAL CARE OF RHODE ISLAND, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:OTR / L
Authorized Official - Phone:401-726-7744
Mailing Address - Street 1:1525 LOUISQUISSET PIKE
Mailing Address - Street 2:BUILDING A SUITE 205
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-4503
Mailing Address - Country:US
Mailing Address - Phone:401-726-7744
Mailing Address - Fax:401-726-7774
Practice Address - Street 1:1525 LOUISQUISSET PIKE
Practice Address - Street 2:BUILDING A SUITE 205
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-4503
Practice Address - Country:US
Practice Address - Phone:401-726-7744
Practice Address - Fax:401-726-7774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIHNC00296251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI5869-0OtherBCBS OF RI
RI1022615OtherUNITED HEALTH CARE OF NE
RIVC51541Medicaid
RIVC53434Medicaid
RI30263OtherNHPRI
RI411764OtherBLUE CHIP COORDINATED PAR
RIVC51541Medicaid