Provider Demographics
NPI:1396726006
Name:HEALTHCARE SOUTH PC
Entity type:Organization
Organization Name:HEALTHCARE SOUTH PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPEDDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-383-6261
Mailing Address - Street 1:97 LIBBEY PKWY
Mailing Address - Street 2:SUITE 204
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02189-3110
Mailing Address - Country:US
Mailing Address - Phone:781-803-2786
Mailing Address - Fax:781-812-1631
Practice Address - Street 1:97 LIBBEY PKWY
Practice Address - Street 2:SUITE 204
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02189-3110
Practice Address - Country:US
Practice Address - Phone:781-803-2786
Practice Address - Fax:781-812-1631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-09
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty