Provider Demographics
NPI:1164508206
Name:RHODE ISLAND HOSPITAL
Entity Type:Organization
Organization Name:RHODE ISLAND HOSPITAL
Other - Org Name:RHODE ISLAND COMPREHENSIVE BREAST CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:EVP & CFO
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:K
Authorized Official - Last Name:MARKELL
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:401-444-5293
Mailing Address - Fax:401-444-4218
Practice Address - Street 1:593 EDDY ST
Practice Address - Street 2:MAIN 1
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4923
Practice Address - Country:US
Practice Address - Phone:401-444-5293
Practice Address - Fax:401-444-4218
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RHODE ISLAND HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-31
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIBC13362Medicaid