Green Line Express LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

GREEN LINE EXPRESS LLC

Practice address

245 Main St
Wakefield, RI 02879-3527

Phone

(401) 360-3500

NPI assigned

Sep 10, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Christina Procaccianti, PHARMD

Title

Facility Administrator

Phone

(401) 360-3200

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1631232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631232000000",
    "number": "1043989288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 MAIN ST",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028793527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 MAIN ST",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028793527",
            "telephone_number": "401-360-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN LINE EXPRESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-10",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A",
        "authorized_official_last_name": "PROCACCIANTI",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "FACILITY ADMINISTRATOR",
        "authorized_official_telephone_number": "401-360-3200",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMBULATORY CARE FACILITY LICENSE",
            "identifier": "01645",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John D Graham, MD
• Heather Mae Grant, PHARM.D.
• Patricia F Graves, LICSW
• Green Line Apothecary LLC
• Green Line Apothecary LLC
• Terese Tanski Gregg, LICSW
• James Francis Griffin, D.O.
• Patricia Ann Grimes
• Grounded in Growth, LLC
• Kerrie L Grow, PT

• Clinic/Center in Wakefield, RI
• Providers in Wakefield, RI by specialty
• Clinic/Center in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.