Provider Demographics
NPI:1609945252
Name:AWCRI MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:AWCRI MEDICAL GROUP, INC.
Other - Org Name:WOMEN'S CARE, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BEAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-727-4800
Mailing Address - Street 1:407 EAST AVE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-5299
Mailing Address - Country:US
Mailing Address - Phone:401-727-4800
Mailing Address - Fax:401-728-4437
Practice Address - Street 1:407 EAST AVE
Practice Address - Street 2:SUITE 150
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-5299
Practice Address - Country:US
Practice Address - Phone:401-727-4800
Practice Address - Fax:401-728-4437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIWC00243Medicaid
RI169020643Medicare ID - Type Unspecified