Healthcare Provider Details

I. General information

NPI: 1053302646
Provider Name (Legal Business Name): MEDHELP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 06/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

539 FARMINGTON AVE
BRISTOL CT
06010-3931
US

IV. Provider business mailing address

PO BOX 1120
BRISTOL CT
06011-1120
US

V. Phone/Fax

Practice location:
  • Phone: 860-314-6046
  • Fax: 860-314-6047
Mailing address:
  • Phone: 860-585-3906
  • Fax: 860-585-3907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LEONARD BANCO
Title or Position: VICE PRESIDENT
Credential:
Phone: 860-585-3772