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General NPI Number Information
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NPI Number | 1891895090
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Entity Type | Organization
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Legal Business Name | SOUTH COUNTY CARDIOLOGY ASSOCIATES, INC.
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 426 SCRABBLETOWN RD SUITE F
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City | NORTH KINGSTOWN
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State | RI
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Zip | 02852-3649
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Country | US
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Telephone | 401-294-5831
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Fax | 401-294-7291
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Provider Business Mailing Address
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Address Line | 426 SCRABBLETOWN RD SUITE F
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City | NORTH KINGSTOWN
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State | RI
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Zip | 02852-3649
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Country | US
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Telephone | 401-294-5831
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Fax | 401-294-7291
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | LISA M POISSON
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Credential |
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Telephone | 401-294-5831
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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