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General NPI Number Information
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NPI Number | 1225152085
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Entity Type | Organization
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Legal Business Name | SOUTH COUNTY PULMONARY MEDICINE, INC
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 09/03/2013
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Provider Practice Location Address
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Address Line | 360 KINGSTOWN ROAD STE 207
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City | NARRAGANSETT
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State | RI
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Zip | 02882-3239
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Country | US
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Telephone | 401-789-0774
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Fax | 401-789-1355
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Provider Business Mailing Address
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Address Line | 360 KINGSTOWN ROAD STE 207
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City | NARRAGANSETT
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State | RI
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Zip | 02882-3239
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Country | US
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Telephone | 401-789-0774
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Fax | 401-789-1355
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Authorized Official
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Title or Position | PRESIDENT SOUTH COUNTY PULMONARY
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Name | DR. ANNE M HEBERT
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Credential | MD
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Telephone | 401-789-0774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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