Organization
PULMONARY ASSOCIATES OF SOUTHSIDE VIRGINIA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNETTE W HARDY (SECRETARY)
(434) 575-5864
Entity
Organization
Contact information
Practice address
2210 WILBORN AVENUE, SOUTH BOSTON, VA 24592
(434) 575-5864
(434) 575-8929
Mailing address
2210 WILBORN AVENUE, SOUTH BOSTON, VA 24592
(434) 575-5864
(434) 575-8929
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890266T
—
NC
Enumeration date
06/09/2005
Last updated
11/15/2010
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