Vaillancourt, Henry R
Vaillancourt, Henry R is an individual health care provider with primary practice located at 1030 President Ave Suite 104 Southcoast Physician Services Inc, Fall River MA 02720-5923. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Vaillancourt, Henry R can be contacted via phone (508) 676-3411.Contact Information
Primary practice address
1030 President Ave Suite 104 Southcoast Physician Services Inc
Fall River MA 02720-5923
Phone: (508) 676-3411
Fax: (508) 235-6656
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 42866 | Massachusetts |
Profile Details
| NPI number | 1093770059 |
|---|---|
| LBN Legal business name | Vaillancourt, Henry R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 20th, 2006 |
| Last updated | Jul 9th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093770059 | NPPES |
| Rhode Island | Other | 0000025599 | BLUE SHIELD |
| Rhode Island | Other | 60417 | BLUE SHIELD |
| Rhode Island | Other | B10491301 | BLUE SHIELD |
| Rhode Island | Other | 004393 | BLUE SHIELD |
| Rhode Island | Other | 000000021256 | BLUE SHIELD |
| Rhode Island | MEDICAID | 2069199 | BLUE SHIELD |
| Rhode Island | Other | K08341 | BLUE SHIELD |
| Rhode Island | Other | 0101462 | BLUE SHIELD |
| Rhode Island | Other | 764242 | BLUE SHIELD |
| Rhode Island | Other | 0016215 | BLUE SHIELD |
| Rhode Island | Other | 3684748 | BLUE SHIELD |
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