Healthcare Provider Details

I. General information

NPI: 1023441938
Provider Name (Legal Business Name): XALON HOME HEALTH SUPPLIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2013
Last Update Date: 08/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

167 HARWINTON AVE APT 9
TORRINGTON CT
06790-6564
US

IV. Provider business mailing address

PO BOX 474
TORRINGTON CT
06790-0474
US

V. Phone/Fax

Practice location:
  • Phone: 860-480-7713
  • Fax: 860-201-1047
Mailing address:
  • Phone: 860-480-7713
  • Fax: 860-201-1047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1033641
License Number StateCT

VIII. Authorized Official

Name: MS. CHERI CHRISTIE
Title or Position: OWNER
Credential:
Phone: 860-480-7713