Healthcare Provider Details

I. General information

NPI: 1982835856
Provider Name (Legal Business Name): ABSORBENT SPECIALTY PRODUCTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2009
Last Update Date: 09/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

413 CENTRAL AVE STE 10
PAWTUCKET RI
02861-1967
US

IV. Provider business mailing address

413 CENTRAL AVE STE 10
PAWTUCKET RI
02861-1967
US

V. Phone/Fax

Practice location:
  • Phone: 401-722-1177
  • Fax: 401-722-1160
Mailing address:
  • Phone: 401-722-1177
  • Fax: 401-722-1160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. CAROL DANCER
Title or Position: PRESIDENT
Credential:
Phone: 401-722-1177