Provider Demographics
NPI:1073544664
Name:BLOCK ISLAND HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:BLOCK ISLAND HEALTH SERVICES, INC.
Other - Org Name:BLOCK ISLAND MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:STOVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-466-2125
Mailing Address - Street 1:P.O. BOX 919
Mailing Address - Street 2:6 PAYNE ROAD
Mailing Address - City:BLOCK ISLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02807-0919
Mailing Address - Country:US
Mailing Address - Phone:401-466-2125
Mailing Address - Fax:401-466-5476
Practice Address - Street 1:6 PAYNE ROAD
Practice Address - Street 2:
Practice Address - City:BLOCK ISLAND
Practice Address - State:RI
Practice Address - Zip Code:02807-0919
Practice Address - Country:US
Practice Address - Phone:401-466-2125
Practice Address - Fax:401-466-5476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIACF01524261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center