Hillside Avenue Family and Community Medicine, LLC
NPI #1447392469 in Pawtucket, Rhode Island
Provider Information
- NPI Number
- 1447392469
- Entity Type
- Organization
- Organization Name
- Hillside Avenue Family and Community Medicine, LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- MEDVANTX, INC.
- Primary Specialty
- Non-Pharmacy Dispensing Site
- Enumeration Date
- Feb 13, 2007
- Last Updated
- Oct 17, 2012
Practice Location
- Address
- 727 EAST AVE
- City
- Pawtucket
- State
- Rhode Island
- ZIP Code
- 02860-6184
- Phone
- (401) 724-6160
Authorized Official
- Name
- KENNY HEINE
- Title
- DIRECTOR OF OPERATIONS
- Phone
- (858) 625-2990
Specialties & Taxonomy Codes
| Specialty |
|---|
| Non-Pharmacy Dispensing Site |
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