Provider Demographics
NPI:1275514093
Name:RJ HOLDING COMPANY LLC
Entity Type:Organization
Organization Name:RJ HOLDING COMPANY LLC
Other - Org Name:WOMENS MEDICAL CENTER OF RI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:DIORIO
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:401-467-9111
Mailing Address - Street 1:1725 BROAD STREET
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02905
Mailing Address - Country:US
Mailing Address - Phone:401-467-9111
Mailing Address - Fax:401-461-1390
Practice Address - Street 1:1725 BROAD ST
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02905
Practice Address - Country:US
Practice Address - Phone:401-467-9111
Practice Address - Fax:401-461-1390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-09
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI1001261QA0005X, 261QF0050X, 261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI002427OtherBLUECHIP
RIW034514Medicaid
RI5715OtherBLUE CROSS OF RI
RI169004300Medicare ID - Type Unspecified