Healthcare Provider Details

I. General information

NPI: 1619354784
Provider Name (Legal Business Name): WESTFORD MEDICAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2015
Last Update Date: 04/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

808 HERCULES DR
COLCHESTER VT
05446-5839
US

IV. Provider business mailing address

808 HERCULES DR
COLCHESTER VT
05446-5839
US

V. Phone/Fax

Practice location:
  • Phone: 802-497-2253
  • Fax: 802-497-3601
Mailing address:
  • Phone: 802-497-2253
  • Fax: 802-497-3601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SANITA HARVIE
Title or Position: PRESIDENT
Credential:
Phone: 802-497-2253