Granite Harbor Business Development LLC
Organization Active NPI Registered Dietitian · West Warwick, RI
NPI 1962685263 · NPPES record last updated Nov 3, 2017
Key facts
- NPI
- 1962685263
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Registered Dietitian 133V00000X
- Legal business name
- GRANITE HARBOR BUSINESS DEVELOPMENT LLC
- Practice address
- 1 James P. Murphy Industrial Highway
West Warwick, RI 02893 - Phone
- (401) 615-5538
- Fax
- (401) 615-8137
- NPI assigned
- Dec 10, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Timothy McCarthy
- Title
- Manager
- Phone
- (603) 867-8003
Practitioners 5
-
Diana Rose Beaton, R.D.
-
Karen Joan Zangari, R.D.
-
Lindsay E Baker, MS, RD, LDN
-
Melissa S Pincince, MS, RD, LDN
-
Suzette Maria Decastro, MPH, MS, RDN, FAND
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in RI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20121005000087 | RI | Part B Supplier - Clinic/Group Practice | 0446409551 |
Receives reassigned benefits from 2 practitioners Practice locations: West Warwick, RI |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian |
133V00000X | Yes | ||
| Point of Service | 305S00000X |
Addresses
Primary practice location
1 James P. Murphy Industrial Highway
West Warwick, RI 02893
Mailing address
PO Box 7782
Warwick, RI 02887-7782
Phone (603) 867-8003
Other names
- Nutrition Consultants LLC
Other providers in West Warwick, RI
- Kathleen Ann Glancy
- Arnold Goldberg
- Brian Elliott Goldstein
- Sonia B Gonzalez
- Tish Graham
- Meghan Elizabeth Grant
- James Douglas Michael Groat
- Natali F Guzman
- Zahid Hameed
- Krista Handfield
All providers in West Warwick, RI · Registered Dietitian in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 3, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.