Thundermist Health Center

LBN: Thundermist Health Center
Thundermist Health Center is an health care organization with primary practice located at 1 River St , Wakefield RI 02879-3214. The organization recently has 2 registered licenses in different health care specialties including Agencies / Community/Behavioral Health, Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC). Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) is the primary health care specialty. Thundermist Health Center can be contacted via phone (401) 783-0523, or through Agudelo, Ckarla via phone (401) 767-4100.

Contact Information

Primary practice address
1 River St Wakefield RI 02879-3214
Fax: (401) 783-9448
Website:
Authorized official contact:
Name: Agudelo, Ckarla

Health care specialties

SpecialtyCodeLicense #State
Agencies / Community/Behavioral Health 251S00000X ACF01566 Rhode Island
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X ACF01566 Rhode Island

Profile Details

NPI number 1700041001
LBN Legal business name Thundermist Health Center
DBA Doing business as
Authorized official Agudelo, Ckarla
Entity Organization
Organization subpart 1 No
Enumeration date Jul 25th, 2008
Last updated Jun 6th, 2019 - about 7 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 1700041001 NPPES
Rhode Island MEDICAID 4101805

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