Healthcare Provider Details

I. General information

NPI: 1336226125
Provider Name (Legal Business Name): COVENTRY IMAGING ASSOC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 04/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 SANDY BOTTOM RD
COVENTRY RI
02816-5863
US

IV. Provider business mailing address

71 SANDY BOTTOM RD
COVENTRY RI
02816-5863
US

V. Phone/Fax

Practice location:
  • Phone: 401-822-0300
  • Fax: 401-822-8701
Mailing address:
  • Phone: 401-822-0300
  • Fax: 401-822-8701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. DONALD HILL
Title or Position: PRACTICE MANAGER/COO
Credential:
Phone: 401-822-8700