Basic Information
| Provider Information | |||||||||
| NPI: | 1306365812 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SILVER SPRING HEALTH CARE MANAGEMENT, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 229 | ||||||||
| Address2: | |||||||||
| City: | WAKEFIELD | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028800229 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4017888757 | ||||||||
| FaxNumber: | 4017829867 | ||||||||
| Practice Location | |||||||||
| Address1: | 14 WOODRUFF AVE STE 1 | ||||||||
| Address2: | |||||||||
| City: | NARRAGANSETT | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028823467 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4017898543 | ||||||||
| FaxNumber: | 4017828766 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2017 | ||||||||
| LastUpdateDate: | 02/10/2022 | ||||||||
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| AuthorizedOfficialLastName: | POLHEMUS | ||||||||
| AuthorizedOfficialFirstName: | MARCIA | ||||||||
| AuthorizedOfficialMiddleName: | T | ||||||||
| AuthorizedOfficialTitleorPosition: | CONTROLLER | ||||||||
| AuthorizedOfficialTelephone: | 4017881974 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 02/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 207RA0000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Adolescent Medicine | 363LA2200X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | 363LF0000X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 207Q00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.