CODAC INC NPI 1629632609

NPI Information

  • NPI: 1629632609
  • Provider Name: CODAC INC
  • Classification: Clinic/Center - 261QM2800X
  • Specialization: Methadone
  • Entity Type: Organization
  • Address: 600 PAWTUCKET AVE
    PAWTUCKET, RI
    ZIP 02860
  • Phone: (401) 808-6278

Map and Directions

Get Directions

NPI Details

CODAC INC is a methadone clinic center in Pawtucket, RI. The provider is an entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. CODAC INC NPI is 1629632609. The provider is registered as an organization entity type.

The provider's business location address is:

600 PAWTUCKET AVE
PAWTUCKET, RI
ZIP 02860-059
Phone: (401) 808-6278
Fax: (401) 808-6957

The provider's authorized official is Alisha M Bourdeau .
The authorized official title is Cfo and has the following contact phone number (401) 275-5038.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatm (HCPCS:G2067)
  • Take-home supply of methadone; up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure (HCPCS:G2078)

The enumeration date for this NPI number is 4/25/2019 and was last updated on 12/21/2021.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251K00000XPublic Health or WelfareNo
2261QM2800XClinic/CenterMethadoneYes
3261QP2300XClinic/CenterPrimary CareNo
4261QR0400XClinic/CenterRehabilitationNo
5261QR0405XClinic/CenterRehabilitation, Substance Use DisorderNo
6175T00000XPeer SpecialistNo

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1CO71983MEDICAIDRHODE 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: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI