Provider Demographics
NPI:1689018467
Name:UNIVERSITY OF RHODE ISLAND
Entity Type:Organization
Organization Name:UNIVERSITY OF RHODE ISLAND
Other - Org Name:UNIVERSITY OF RHODE ISLAND HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:BS PHARMACY
Authorized Official - Phone:401-874-5155
Mailing Address - Street 1:6 QUARRY RD
Mailing Address - Street 2:POTTER BLDG
Mailing Address - City:KINGSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02881-1116
Mailing Address - Country:US
Mailing Address - Phone:401-874-4775
Mailing Address - Fax:401-874-2586
Practice Address - Street 1:6 QUARRY RD
Practice Address - Street 2:POTTER BLDG
Practice Address - City:KINGSTON
Practice Address - State:RI
Practice Address - Zip Code:02881-1116
Practice Address - Country:US
Practice Address - Phone:401-874-4775
Practice Address - Fax:401-874-7611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-23
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
RIPHB000013336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2088227OtherPK