Provider Demographics
NPI:1831378942
Name:SCITUATE CHIROPRACTIC CENTER INC
Entity type:Organization
Organization Name:SCITUATE CHIROPRACTIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:D
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:401-934-0077
Mailing Address - Street 1:6 VILLAGE PLAZA WAY
Mailing Address - Street 2:
Mailing Address - City:N SCITUATE
Mailing Address - State:RI
Mailing Address - Zip Code:02857-1849
Mailing Address - Country:US
Mailing Address - Phone:401-934-0077
Mailing Address - Fax:401-934-2960
Practice Address - Street 1:6 VILLAGE PLAZA WAY
Practice Address - Street 2:
Practice Address - City:N SCITUATE
Practice Address - State:RI
Practice Address - Zip Code:02857-1849
Practice Address - Country:US
Practice Address - Phone:401-934-0077
Practice Address - Fax:401-934-2960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI400290OtherBLUE CHIP RI
RI440257OtherUNITED HEALTH
RI9035OtherBLUE CROSS OF RI
RI400290OtherBLUE CHIP RI
RI359002969Medicare PIN
RI440257OtherUNITED HEALTH