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General NPI Number Information
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NPI Number | 1871994293
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Entity Type | Organization
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Legal Business Name | FERGUSON ANIMAL HOSPITAL
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Dates
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Enumeration Date | 09/05/2014
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Last Update Date | 09/05/2014
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Provider Practice Location Address
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Address Line | 660 WOONASQUATUCKET AVE
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City | NORTH PROVIDENCE
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State | RI
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Zip | 02911-1623
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Country | US
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Telephone | 401-349-4280
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Fax |
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Provider Business Mailing Address
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Address Line | 660 WOONASQUATUCKET AVE
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City | NORTH PROVIDENCE
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State | RI
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Zip | 02911-1623
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. FRED GLOM
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Credential |
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Telephone | 401-349-4280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | DVM00947
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License Number State | RI
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