The Tavares Pediatric Center Inc

LBN: The Tavares Pediatric Center Inc
The Tavares Pediatric Center Inc is an health care organization with primary practice located at 101 Plain St , Providence RI 02903-4824. The organization recently has 2 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Skilled Nursing Facility, Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded. Nursing & Custodial Care Facilities / Skilled Nursing Facility is the primary health care specialty. The Tavares Pediatric Center Inc can be contacted via phone (401) 272-7127, or through Tavares, Eugene F via phone (401) 272-7127.

Contact Information

Primary practice address
101 Plain St Providence RI 02903-4824
Phone: (401) 272-7127
Fax: (401) 272-4752
Website:
Map and Directions
Authorized official contact:
Name: Tavares, Eugene F LICENSED
Phone: (401) 272-7127

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X RI 642 Rhode Island
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X RI 642 Rhode Island

Profile Details

NPI number 1366442899
LBN Legal business name The Tavares Pediatric Center Inc
DBA Doing business as
Authorized official Tavares, Eugene F LICENSED
Entity Organization
Organization subpart 1 No
Enumeration date Jul 27th, 2005
Last updated Aug 22nd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366442899 NPPES
Rhode Island MEDICAID 41G085

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