Provider Demographics
NPI: | 1962844795 |
---|---|
Name: | RHODE ISLAND HOSPITAL |
Entity type: | Organization |
Organization Name: | RHODE ISLAND HOSPITAL |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | EXECUTIVE VP & CFO |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | DAVID |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | KIRSHNER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 401-444-7914 |
Mailing Address - Street 1: | 117 ELLENFIELD ST |
Mailing Address - Street 2: | |
Mailing Address - City: | PROVIDENCE |
Mailing Address - State: | RI |
Mailing Address - Zip Code: | 02905-4513 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 401-444-6905 |
Mailing Address - Fax: | 401-444-5462 |
Practice Address - Street 1: | 593 EDDY ST |
Practice Address - Street 2: | GEORGE BLDG., 1ST FLOOR |
Practice Address - City: | PROVIDENCE |
Practice Address - State: | RI |
Practice Address - Zip Code: | 02903-4923 |
Practice Address - Country: | US |
Practice Address - Phone: | 401-606-1004 |
Practice Address - Fax: | 401-606-1153 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | LIFESPAN CORPORATION |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2013-07-22 |
Last Update Date: | 2022-10-11 |
Deactivation Date: | 2019-01-03 |
Deactivation Code: | |
Reactivation Date: | 2022-08-19 |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
103TC0700X, 207RA0001X, 207RC0000X, 207RC0001X, 207RI0011X, 363A00000X, 363AM0700X, 363AS0400X, 363L00000X, 363LA2100X, 363LA2200X, 363LF0000X | ||
RI | HOS | 207RC0000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207RA0001X | Allopathic & Osteopathic Physicians | Internal Medicine | Advanced Heart Failure and Transplant Cardiology | Group - Multi-Specialty |
No | 103TC0700X | Behavioral Health & Social Service Providers | Psychologist | Clinical | Group - Multi-Specialty |
No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Single Specialty |
No | 207RC0001X | Allopathic & Osteopathic Physicians | Internal Medicine | Clinical Cardiac Electrophysiology | Group - Multi-Specialty |
No | 207RI0011X | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | Group - Multi-Specialty |
No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Group - Multi-Specialty | |
No | 363AM0700X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | Group - Multi-Specialty |
No | 363AS0400X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical | Group - Multi-Specialty |
No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty | |
No | 363LA2100X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care | Group - Multi-Specialty |
No | 363LA2200X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | Group - Multi-Specialty |
No | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | Group - Multi-Specialty |