Healthcare Provider Details

I. General information

NPI: 1609105147
Provider Name (Legal Business Name): ASSOCIATED MEDICAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2009
Last Update Date: 07/27/2023
Certification Date: 07/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 SYCAMORE WAY, UNIT 2
BRANFORD CT
06405-2935
US

IV. Provider business mailing address

7 SYCAMORE WAY, UNIT 2
BRANFORD CT
06405-2935
US

V. Phone/Fax

Practice location:
  • Phone: 203-204-2874
  • Fax: 860-865-0350
Mailing address:
  • Phone: 203-204-2874
  • Fax: 860-865-0350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. MARCUS K SIMPSON
Title or Position: PRESIDENT
Credential:
Phone: 203-204-2874