Codac INC
Clinic/Center, Methadone Clinic in Pawtucket, Rhode Island
1629632609- Practice location
- 600 Pawtucket Ave, Pawtucket, RI 02860-6059
- Phone
- 401-808-6278
- Fax
- 401-808-6957
- Last updated
- December 21, 2021
Codac INC is a healthcare organization based in Pawtucket, RI. Codac INC practices in Pawtucket, RI. The NPI Number for Codac INC is 1629632609. The current practice location address for Codac INC is 600 Pawtucket Ave, Pawtucket, RI 02860-6059 and can be reached out via phone at 401-808-6278 and via fax at 401-808-6957.
Provider Profile Details
- NPI Number
- 1629632609
- Provider Name
- Codac INC
- Provider Entity Type
- Organization
- Address
- 600 Pawtucket Ave, Pawtucket, RI 02860-6059
- Phone Number
- 401-808-6278
- Fax Number
- 401-808-6957
- Primary Taxonomy
- Clinic/Center, Methadone Clinic · 261QM2800X
- Organization Subpart
- No
- Authorized Official
- Alisha M Bourdeau · Cfo · 401-275-5038
- Other Names
- Codac Pawtucket Ave (Doing Business As)
- Provider Enumeration Date
- April 25, 2019
- Last Update Date
- December 21, 2021
- Certification Date
- December 21, 2021
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 600 Pawtucket Ave
Pawtucket, RI 02860-6059 - City
- Pawtucket
- State
- Rhode Island
- Zip
- 02860-6059
- Phone Number
- 401-808-6278
- 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
- 401-275-5038
- Fax Number
- 401-942-3590
License Information
- Taxonomy (1)
- Peer Specialist · 175T00000X
- Taxonomy (2)
- Public Health or Welfare · 251K00000X
- Taxonomy (3)
- Clinic/Center, Primary Care · 261QP2300X
- Taxonomy (4)
- Clinic/Center, Rehabilitation · 261QR0400X
- Taxonomy (5)
- Clinic/Center, Rehabilitation, Substance Use Disorder · 261QR0405X
- Taxonomy (6)
- 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. | |||
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Frequently Asked Questions
What is the NPI number of Codac INC?
The NPI number of Codac INC is 1629632609. It was assigned on April 25, 2019 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).
Where does Codac INC practice?
The practice location is 600 Pawtucket Ave, Pawtucket, RI 02860-6059. The office can be reached at 401-808-6278 (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 1629632609 directly on the NPPES registry website.