| South County Internal Medicine, Inc. | |
|
481 Kingstown Rd Wakefield RI 02879-3626 | |
| (401) 789-0283 | |
| (401) 789-0314 |
| Full Name | South County Internal Medicine, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 481 Kingstown Rd, Wakefield, Rhode Island |
| Authorized Official Name and Position | Sharin M Guerrieri (MANAGER ENROLLMENT) |
| Authorized Official Contact | 4017890283 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South County Internal Medicine, Inc. 481 Kingstown Rd Wakefield RI 02879-3626 Ph: (401) 789-0283 | South County Internal Medicine, Inc. 481 Kingstown Rd Wakefield RI 02879-3626 Ph: (401) 789-0283 |
| NPI Number | 1215946827 |
|---|---|
| Provider Enumeration Date | 08/05/2006 |
| Last Update Date | 04/26/2017 |
| Medicare PECOS PAC ID | 9032003017 |
|---|---|
| Medicare Enrollment ID | O20040211000100 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215946827 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Timothy J Omara |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205879608 PECOS PAC ID: 3971564386 Enrollment ID: I20041020000016 |
| Provider Name | Nitin S Damle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457399388 PECOS PAC ID: 3173603081 Enrollment ID: I20100909000092 |
| Provider Name | Paul Barratt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528007432 PECOS PAC ID: 6204720295 Enrollment ID: I20100923001292 |
| Provider Name | Monique Pouliot |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285674614 PECOS PAC ID: 1658497979 Enrollment ID: I20100923001338 |
| Provider Name | Sergio F Rodriguez Serrano |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952547846 PECOS PAC ID: 7315134780 Enrollment ID: I20101210000524 |
| Provider Name | Letitia Ann Horrigan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760622617 PECOS PAC ID: 1850563370 Enrollment ID: I20111005000591 |
| Provider Name | Deanna L Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760937650 PECOS PAC ID: 2163700261 Enrollment ID: I20161025000236 |
| Provider Name | John F Mullaney |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669484929 PECOS PAC ID: 9436299559 Enrollment ID: I20200812001070 |
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