Provider Demographics
NPI:1831521202
Name:HEALTHCENTRIC, LLC
Entity type:Organization
Organization Name:HEALTHCENTRIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:HUGO
Authorized Official - Middle Name:M
Authorized Official - Last Name:YAMADA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-334-6252
Mailing Address - Street 1:6 BLACKSTONE VALLEY PL
Mailing Address - Street 2:SUITE 502
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-1179
Mailing Address - Country:US
Mailing Address - Phone:401-334-6252
Mailing Address - Fax:401-334-6262
Practice Address - Street 1:6 BLACKSTONE VALLEY PL
Practice Address - Street 2:SUITE 502
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-1179
Practice Address - Country:US
Practice Address - Phone:401-334-6252
Practice Address - Fax:401-334-6262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-07
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RINPP33049363L00000X
207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty