Provider Demographics
NPI:1538254305
Name:SOUTH COUNTY HOSPITAL/DBA SILVER SPRING HEALTHCARE MANAGEMENT, INC.
Entity type:Organization
Organization Name:SOUTH COUNTY HOSPITAL/DBA SILVER SPRING HEALTHCARE MANAGEMENT, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KOZIOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-782-8035
Mailing Address - Street 1:100 KENYON AVE
Mailing Address - Street 2:SOUTH COUNTY HOSPITAL PATHOLOGISTS
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02879
Mailing Address - Country:US
Mailing Address - Phone:401-782-8035
Mailing Address - Fax:401-783-7393
Practice Address - Street 1:100 KENYON AVE
Practice Address - Street 2:SOUTH COUNTY HOSPITAL PATHOLOGISTS
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879
Practice Address - Country:US
Practice Address - Phone:401-782-8035
Practice Address - Fax:401-783-7393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty