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FAIRLAWN PRIMARY CARE INC NPI 1508898909


NPI Information

NPI: 1508898909
Provider Name: FAIRLAWN PRIMARY CARE, INC
Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 41D1027789

Address:
886 MINERAL SPRING AVE
PAWTUCKET, RI
ZIP 02860
Phone: (401) 475-3063
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FAIRLAWN PRIMARY CARE, INC is an internal medicine in Pawtucket, RI. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. FAIRLAWN PRIMARY CARE, INC NPI is 1508898909. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

886 MINERAL SPRING AVE
PAWTUCKET, RI
ZIP 02860-322
Phone: (401) 475-3063

The provider's authorized official is Holly Fernandes .
The authorized official title is President and has the following contact phone number (401) 475-3063.

The CLIA number assigned to this NPI record is 41D1027789 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/7/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal Medicine09843RHODE ISLANDYes
2363LF0000XNurse PractitionerFamilyNPP37132RHODE ISLANDX

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
19003461MEDICAIDRHODE ISLAND
27006714MEDICAIDRHODE ISLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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