Provider Demographics
NPI:1336370691
Name:PROVANT HEALTH SOLUTIONS, LLC
Entity Type:Organization
Organization Name:PROVANT HEALTH SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF CLINICAL SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:B
Authorized Official - Last Name:HAYDON
Authorized Official - Suffix:
Authorized Official - Credentials:BSN,MBA
Authorized Official - Phone:401-885-1463
Mailing Address - Street 1:42 LADD ST
Mailing Address - Street 2:SUITE 214
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-4361
Mailing Address - Country:US
Mailing Address - Phone:401-885-1463
Mailing Address - Fax:401-398-1708
Practice Address - Street 1:42 LADD ST
Practice Address - Street 2:SUITE 214
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-4361
Practice Address - Country:US
Practice Address - Phone:401-885-1463
Practice Address - Fax:401-398-1708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-05
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI000142702332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site