Healthcare Provider Details

I. General information

NPI: 1073693370
Provider Name (Legal Business Name): CAT SCANNING OF NORTH PROVIDENCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1637 MINERAL SPRING AVE
NORTH PROVIDENCE RI
02904-4042
US

IV. Provider business mailing address

71 SANDY BOTTOM RD
COVENTRY RI
02816-5863
US

V. Phone/Fax

Practice location:
  • Phone: 401-354-6093
  • Fax: 401-354-6891
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: VIRGINIA CARR
Title or Position: OFFICE MANAGER
Credential:
Phone: 401-822-0300