Codac INC
Clinic/Center, Methadone Clinic in Providence, Rhode Island
1558712034- Practice location
- 528 N Main St, Providence, RI 02904-5757
- Phone
- 401-808-4278
- Fax
- 401-808-6957
- Last updated
- April 25, 2019
Codac INC is a healthcare organization based in Providence, RI. Codac INC practices in Providence, RI. The NPI Number for Codac INC is 1558712034 and holds a License No. 605.07 (RI). The current practice location address for Codac INC is 528 N Main St, Providence, RI 02904-5757 and can be reached out via phone at 401-808-4278 and via fax at 401-808-6957.
Provider Profile Details
- NPI Number
- 1558712034
- Provider Name
- Codac INC
- Provider Entity Type
- Organization
- Address
- 528 N Main St, Providence, RI 02904-5757
- Phone Number
- 401-808-4278
- Fax Number
- 401-808-6957
- Primary Taxonomy
- Clinic/Center, Methadone Clinic · 261QM2800X
- Organization Subpart
- No
- Authorized Official
- Alisha Bourdeau, BS · Cfo · 401-275-5038
- Other Names
- Codac North Main (Doing Business As)
- Provider Enumeration Date
- June 27, 2016
- Last Update Date
- April 25, 2019
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 528 N Main St
Providence, RI 02904-5757 - City
- Providence
- State
- Rhode Island
- Zip
- 02904-5757
- Phone Number
- 401-808-4278
- Fax Number
- 401-808-6957
Provider Business Mailing Address Details
- Address
- 1052 Park Ave
Cranston, RI 02910-3225 - City
- Cranston
- State
- RI
- Zip
- 02910-3225
- Phone Number
- 401-275-5039
- Fax Number
- 401-942-3590
License Information
- License Number (1)
- 605.07
- License State (1)
- RI
- Taxonomy (1)
- Public Health or Welfare · 251K00000X
- License Number (2)
- 605.07
- License State (2)
- RI
- Taxonomy (2)
- Clinic/Center, Health Services · 261QH0100X
- License Number (3)
- ACF01632
- License State (3)
- RI
- Taxonomy (3)
- Clinic/Center, Primary Care · 261QP2300X
- License Number (4)
- 605.07
- License State (4)
- RI
- Taxonomy (4)
- Clinic/Center, Rehabilitation, Substance Use Disorder · 261QR0405X
- License Number (5)
- 605.07
- License State (5)
- RI
- Taxonomy (5)
- Rehabilitation, Substance Use Disorder Unit · 276400000X
- Taxonomy (6)
- Peer Specialist · 175T00000X
- License Number (7)
- 605.07
- License State (7)
- RI
- Taxonomy (7)
- Clinic/Center, Methadone Clinic · 261QM2800X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Clinic/Center, Methadone Clinic providers near Providence, RI
View all Clinic/Center, Methadone Clinic providers in Providence →Frequently Asked Questions
What is the NPI number of Codac INC?
The NPI number of Codac INC is 1558712034. It was assigned on June 27, 2016 and is currently active in the NPPES registry.
What is the specialty of Codac INC?
Codac INC is registered under the primary taxonomy Clinic/Center, Methadone Clinic (code 261QM2800X), licensed in RI under license number 605.07.
Where does Codac INC practice?
The practice location is 528 N Main St, Providence, RI 02904-5757. The office can be reached at 401-808-4278 (phone) or 401-808-6957 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1558712034 directly on the NPPES registry website.