Healthcare Provider Details
I. General information
NPI: 1659465060
Provider Name (Legal Business Name): BROOKFIELD MEDICAL SURGICAL SUPPLIES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/03/2006
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
60 OLD NEW MILFORD RD STE 2B
BROOKFIELD CT
06804-2430
US
IV. Provider business mailing address
PO BOX 801
BROOKFIELD CT
06804-0801
US
V. Phone/Fax
- Phone: 203-775-9040
- Fax: 203-775-9515
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | PCY.0001469 |
| License Number State | CT |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336H0001X |
| Taxonomy | Home Infusion Therapy Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMES
CANGELOSI
Title or Position: OWNER
Credential: RPH
Phone: 203-775-9040