Provider Demographics
NPI:1356505895
Name:NARRAGANSETT INDIAN HEALTH CENTER
Entity Type:Organization
Organization Name:NARRAGANSETT INDIAN HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JUNISE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLISS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-364-1268
Mailing Address - Street 1:4533 S COUNTY TRL
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02813-3428
Mailing Address - Country:US
Mailing Address - Phone:401-364-1268
Mailing Address - Fax:401-364-6427
Practice Address - Street 1:4533 S COUNTY TRL
Practice Address - Street 2:
Practice Address - City:CHARLESTOWN
Practice Address - State:RI
Practice Address - Zip Code:02813-3428
Practice Address - Country:US
Practice Address - Phone:401-364-1268
Practice Address - Fax:401-364-6427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI261Q00000X261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI4101809Medicaid
RI411890Medicare UPIN