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NPI Code Detail

MEDICARE: 1918 WINTER STREET OPERATING CO LLC

MEDICARE: 1918 WINTER STREET OPERATING CO LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies
2333600000XPharmacy
33336C0003XCommunity/Retail Pharmacy

General Provider Information

NPI Number : 1689445470
Entity Type Code : Organization
Provider Name (Legal Business Name) : 1918 WINTER STREET OPERATING CO LLC
Provider Business Mailing Address
First Line : 7 CORPORATE DR
Second Line :
City : KEENE
State : NH
Zip : 03431-5042
Country : US
Telephone Number : 603-354-7000
Fax Number :
Provider Business Practice Location Address
First Line : 4733 E PALM CANYON DR
Second Line :
City : PALM SPRINGS
State : CA
Zip : 92264-5219
Country : US
Telephone Number : 760-324-8269
Fax Number : 760-202-3432
Authorized Official
Title or Position : AUTHORIZED PERSON
Name : KEVIN MCNAMARA
Credential :
Telephone Number : 603-354-4619
Provider Enumeration Date : 01/11/2024
Last Update Date : 07/24/2024

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Directions to “1918 WINTER STREET OPERATING CO LLC ” Practice Location

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