Provider Demographics
NPI:1497321780
Name:RENATA WOS DBA BHEALTHY
Entity type:Organization
Organization Name:RENATA WOS DBA BHEALTHY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PCP PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:RENATA
Authorized Official - Middle Name:
Authorized Official - Last Name:WOS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:401-338-7772
Mailing Address - Street 1:500 SMITHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-6285
Mailing Address - Country:US
Mailing Address - Phone:401-338-7772
Mailing Address - Fax:
Practice Address - Street 1:525 BROAD ST
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864-6933
Practice Address - Country:US
Practice Address - Phone:401-338-7772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-27
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care