Provider Demographics
NPI:1790193522
Name:SOUTH COUNTY ANESTHESIA ASSOCIATES, LLC
Entity Type:Organization
Organization Name:SOUTH COUNTY ANESTHESIA ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:401-788-0196
Mailing Address - Street 1:1342 BELMONT ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-4436
Mailing Address - Country:US
Mailing Address - Phone:508-580-1670
Mailing Address - Fax:
Practice Address - Street 1:100 KENYON AVE
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879-4216
Practice Address - Country:US
Practice Address - Phone:401-782-8000
Practice Address - Fax:401-789-3450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-24
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty