BANNISTER NURSING CARE CENTER
Nursing Care, Pediatric
Providence, Rhode Island
Provider NPI: 1427177005
Organization Information:Organization Name: BANNISTER NURSING CARE CENTER
Practice Location:
135 DODGE ST PROVIDENCE, RI 02907 US
Tel: 401-521-9600 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
135 DODGE ST PROVIDENCE, RI 02907 US
Tel: 401-521-9600 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 3140N1450X | Nursing & Custodial Care Facilities Skilled Nursing Facility Nursing Care, Pediatric | RI | LTC00600 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
BLUE CROSS | 5005-0 | RI | 01 |
4105038 | RI | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin