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General NPI Number Information
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NPI Number | 1598724007
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Entity Type | Organization
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Legal Business Name | SOUTH COUNTY ARTIFICIAL LIMB CO., INC.
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Dates
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Enumeration Date | 03/22/2006
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Last Update Date | 05/22/2020
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Provider Practice Location Address
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Address Line | 162 MAIN ST
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City | WAKEFIELD
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State | RI
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Zip | 02879-3568
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Country | US
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Telephone | 401-783-0063
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Fax | 401-789-3190
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Provider Business Mailing Address
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Address Line | PO BOX 176
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City | WEST KINGSTON
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State | RI
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Zip | 02892-0176
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Country | US
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Telephone | 401-783-0063
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Fax | 401-789-3190
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Authorized Official
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Title or Position | CORPORATE SECRETARY
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Name | MRS. LOIS A. JAMES
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Credential |
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Telephone | 401-783-0063
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | CP00001
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License Number State | RI
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