Healthcare Provider Details

I. General information

NPI: 1053239186
Provider Name (Legal Business Name): WAY HOMES MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 ASYLUM AVE
HARTFORD CT
06105-3840
US

IV. Provider business mailing address

600 ASYLUM AVE
HARTFORD CT
06105-3840
US

V. Phone/Fax

Practice location:
  • Phone: 586-209-3987
  • Fax:
Mailing address:
  • Phone: 586-209-3987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: SUMITHRA CHUNDRU
Title or Position: OWNER
Credential:
Phone: 307-622-9550