Healthcare Provider Details

I. General information

NPI: 1124294780
Provider Name (Legal Business Name): CONTINENCE CONNECTION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2008
Last Update Date: 06/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 NEWBURYPORT TPKE SUITE 363
ROWLEY MA
01969-2107
US

IV. Provider business mailing address

141 NEWBURYPORT TPKE SUITE 363
ROWLEY MA
01969-2107
US

V. Phone/Fax

Practice location:
  • Phone: 978-356-6993
  • Fax: 978-356-0377
Mailing address:
  • Phone: 978-356-6993
  • Fax: 978-356-0377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: ROBIN PHELAN
Title or Position: MANAGING DIRECTOR
Credential: RN
Phone: 978-356-6993