Healthcare Provider Details
I. General information
NPI: 1760875868
Provider Name (Legal Business Name): SURGICAL RECOVERY SOLUTIONS ,LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/12/2015
Last Update Date: 12/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
257 SOUND BEACH AVE
OLD GREENWICH CT
06870-1607
US
IV. Provider business mailing address
257 SOUND BEACH AVE
OLD GREENWICH CT
06870-1449
US
V. Phone/Fax
- Phone: 203-918-8933
- Fax: 866-202-9300
- Phone: 203-918-8933
- Fax: 866-202-9300
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | CT |
VIII. Authorized Official
Name:
ANIA
RECKO-TULLY
Title or Position: OWNER
Credential:
Phone: 203-918-8933