Provider Demographics
NPI:1639649452
Name:BLOCK ISLAND HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:BLOCK ISLAND HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-466-2974
Mailing Address - Street 1:PO BOX 919
Mailing Address - Street 2:
Mailing Address - City:BLOCK ISLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02807-0919
Mailing Address - Country:US
Mailing Address - Phone:401-466-2974
Mailing Address - Fax:401-466-5476
Practice Address - Street 1:6 PAYNE ROAD
Practice Address - Street 2:
Practice Address - City:BLOCK ISLAND
Practice Address - State:RI
Practice Address - Zip Code:02807-0919
Practice Address - Country:US
Practice Address - Phone:401-466-2974
Practice Address - Fax:401-466-5476
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BLOCK ISLAND HEALTH SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-12-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI9002424Medicaid