NPI 1184010118

Mpch

Organisation Exclusive Provider Organization Providence, RI

Practice location

Address: 149 Pomona Ave, Providence, RI 02908-5123
Phone: (978) 425-4341

Authorised official

Name: Thomas Groblewski
Title: Statewide Medical Director
Phone: (781) 706-1052

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence RN2269378 (MA)

Other Exclusive Provider Organization providers in Rhode Island →

Registry record

NPI: 1184010118
Entity type: Organization
NPI issued: 7 Apr 2015
Record last updated: 7 Apr 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.