Healthcare Provider Details

I. General information

NPI: 1285940726
Provider Name (Legal Business Name): ADVANCED ULTRASOUND MOBILE IMAGING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2010
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

765 MAIN AVE
WARWICK RI
02886-3213
US

IV. Provider business mailing address

765 MAIN AVE
WARWICK RI
02886-3213
US

V. Phone/Fax

Practice location:
  • Phone: 401-737-2229
  • Fax: 888-958-2393
Mailing address:
  • Phone: 401-737-2229
  • Fax: 888-958-2393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. LYNN A BUTLER
Title or Position: PRESIDENT / ULTRASONOGRAPHER
Credential: ARDMS
Phone: 401-737-2229