Healthcare Provider Details

I. General information

NPI: 1710357496
Provider Name (Legal Business Name): M P GOUIN CO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2015
Last Update Date: 10/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 GUILFORD ST
BRATTLEBORO VT
05301-6394
US

IV. Provider business mailing address

500 GUILFORD ST
BRATTLEBORO VT
05301-6394
US

V. Phone/Fax

Practice location:
  • Phone: 802-380-6275
  • Fax:
Mailing address:
  • Phone: 802-380-6275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MICHAEL GOUIN
Title or Position: PRESIDENT
Credential:
Phone: 802-380-6275