Provider Demographics
NPI:1003940735
Name:CARDIOLOGY & INTERNAL MEDICINE ASSOCIATES OF RHODE ISLAND,INC.
Entity Type:Organization
Organization Name:CARDIOLOGY & INTERNAL MEDICINE ASSOCIATES OF RHODE ISLAND,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HANNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-353-7370
Mailing Address - Street 1:214 HIGH SERVICE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-5115
Mailing Address - Country:US
Mailing Address - Phone:401-353-7370
Mailing Address - Fax:401-353-4385
Practice Address - Street 1:214 HIGH SERVICE AVE
Practice Address - Street 2:
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-5115
Practice Address - Country:US
Practice Address - Phone:401-353-7370
Practice Address - Fax:401-353-4385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI9094652Medicaid
RI9094652Medicaid