Provider Demographics
NPI:1851523542
Name:HOPE JACKSON FIRE
Entity Type:Organization
Organization Name:HOPE JACKSON FIRE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OF DEPARTMENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ANDERSON
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:NRSMTP
Authorized Official - Phone:401-828-6460
Mailing Address - Street 1:PO BOX 20104
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-0927
Mailing Address - Country:US
Mailing Address - Phone:401-572-3120
Mailing Address - Fax:401-572-3351
Practice Address - Street 1:117 MAIN ST
Practice Address - Street 2:
Practice Address - City:HOPE
Practice Address - State:RI
Practice Address - Zip Code:02831
Practice Address - Country:US
Practice Address - Phone:401-828-6460
Practice Address - Fax:401-823-5368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-14
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI77341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
239489OtherTUFTS
5907708OtherAETNA
RI5990078871OtherMEDICARE