Provider Demographics
NPI:1932701208
Name:RHODE ISLAND PAIN MANAGEMENT
Entity Type:Organization
Organization Name:RHODE ISLAND PAIN MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:WESCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:401-450-4228
Mailing Address - Street 1:569 MAIN ST STE 105
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:RI
Mailing Address - Zip Code:02885-4417
Mailing Address - Country:US
Mailing Address - Phone:401-253-0380
Mailing Address - Fax:
Practice Address - Street 1:569 MAIN ST STE 105
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:RI
Practice Address - Zip Code:02885-4417
Practice Address - Country:US
Practice Address - Phone:401-253-0380
Practice Address - Fax:508-659-6742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain