Organization · Type 2 NPI

The Miriam Hospital

Medical Specialty Clinic/Center · Providence, RI

NPI number 1275810434 Active

Practice location

180 Corliss St Ste E1
Providence, RI 02904-2602

Call (401) 793-7401 Map

Mailing address

15 La Salle Sq
Providence, RI 02903-1814

Other practice locations

180 Corliss St Ste F, Providence, RI 02904-2602 · (401) 793-4715
180 Corliss St Ste E2, Providence, RI 02904-2602 · (401) 793-2928

Specialties and licenses

Taxonomy	Code	License
Clinical Psychologist	103TC0700X	None listed
Clinical Social Worker	1041C0700X	None listed
Psychiatry Physician	2084P0800X	None listed
Medical Specialty Clinic/Center Primary	261QM2500X	HOS00122 (RI)

Medical Specialty Clinic/Center: An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

4 other providers at this address

Other medical specialty clinic/center providers in Providence

See all in Providence →

NPI record

NPI: 1275810434
Entity type: Organization (Type 2)
Issued: Nov 15, 2011
Last updated: Dec 11, 2025
Status: Active
Subpart: Yes of Lifespan Corporation

Other names

<unavail>
Immunology Center at the Miriam Hospital · other name
Immunology Center at the Miriam Hospital · other name

Authorized official

Mr. Peter K Markell
EVP & CFO
(401) 444-7914

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1275810434

The Miriam Hospital's National Provider Identifier is 1275810434, issued on Nov 15, 2011. The primary taxonomy on file is Medical Specialty Clinic/Center (261QM2500X), and the practice location is in Providence, RI. The record was last updated on Dec 11, 2025.