Healthcare Provider Details

I. General information

NPI: 1831187145
Provider Name (Legal Business Name): MED NOW PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 03/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 BARNUM AVE
STRATFORD CT
06614-4968
US

IV. Provider business mailing address

1040 BARNUM AVE
STRATFORD CT
06614-4968
US

V. Phone/Fax

Practice location:
  • Phone: 203-377-5733
  • Fax: 203-380-0851
Mailing address:
  • Phone: 203-377-5733
  • Fax: 203-380-0851

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: MR. C WAYNE MELLOR
Title or Position: GENERAL MANAGER
Credential:
Phone: 203-377-5733