Healthcare Provider Details

I. General information

NPI: 1689059503
Provider Name (Legal Business Name): ASSOCIATED MEDICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2015
Last Update Date: 07/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1730 POST RD
WARWICK RI
02888-5941
US

IV. Provider business mailing address

21 BUSINESS PARK DR
BRANFORD CT
06405-2935
US

V. Phone/Fax

Practice location:
  • Phone: 203-204-2874
  • Fax: 860-865-0350
Mailing address:
  • Phone: 203-204-2874
  • Fax: 860-865-0350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. MARCUS K SIMPSON
Title or Position: PRESIDENT
Credential:
Phone: 203-204-2874