Organization
SOUTH COUNTY PHYSICIANS AND SURGEONS INC - OPTICAL SHOPE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS J COGHLIN MD (PRESIDENT CEO)
(401) 294-4506
Entity
Organization
Contact information
Practice address
65 BOSTON NECK ROAD, SOUTH COUNTY EYE PHYSICIANS AND SURGEONS INC, NORTH KINGSTOWN, RI 02852-5704
(401) 295-0723
(401) 295-8870
Mailing address
65 BOSTON NECK ROAD, SOUTH COUNTY EYE PHYSICIANS AND SURGEONS INC, NORTH KINGSTOWN, RI 02852-5704
(401) 295-0723
(401) 295-8870
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0963
NEIGHBORHOOD HEALTH PLAN
RI
05
—
9000324
—
RI
Enumeration date
05/18/2006
Last updated
08/22/2020
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