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Contact Information

PROSPECT CHARTERCARE SJHSRI, LLC
200 HIGH SERVICE AVE
NORTH PROVIDENCE, RI02904-5113
 Phone: 401-456-3000
 Fax: 401-456-3028
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
 

Nutrition, Education

133NN1002X
Indicates primary specialty

NPI Profile & details for PROSPECT CHARTERCARE SJHSRI, LLC

NPI # 1578988572
LBN Legal business name PROSPECT CHARTERCARE SJHSRI, LLC
Authorized official ROBERT ELDERS - (SECRETARY)
Entity Organization
Organization subpart 1 No
Enumeration date 02/27/2014
Last updated 01/15/2021 - About 5 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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