Provider Demographics
NPI:1386689149
Name:WARWICK HEALTH CENTRE INC.
Entity Type:Organization
Organization Name:WARWICK HEALTH CENTRE INC.
Other - Org Name:WEST SHORE HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:FERNANDES
Authorized Official - Last Name:DAROSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-739-9440
Mailing Address - Street 1:109 W SHORE RD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02889-1102
Mailing Address - Country:US
Mailing Address - Phone:401-739-9440
Mailing Address - Fax:401-739-5792
Practice Address - Street 1:109 W SHORE RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02889-1102
Practice Address - Country:US
Practice Address - Phone:401-739-9440
Practice Address - Fax:401-739-5792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI719314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIWH-30941Medicaid
RIWH-30941Medicaid