Healthcare Provider Details

I. General information

NPI: 1346521952
Provider Name (Legal Business Name): C & M SPECIALIZED ENTERPRISES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2011
Last Update Date: 09/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 WHEELOCK RD
SUTTON VT
05867-9670
US

IV. Provider business mailing address

PO BOX 225
LYNDONVILLE VT
05851-0225
US

V. Phone/Fax

Practice location:
  • Phone: 802-467-3496
  • Fax: 802-467-3496
Mailing address:
  • Phone: 802-467-3496
  • Fax: 802-467-3496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARY A GRAY
Title or Position: CORPORATE SECRETARY
Credential:
Phone: 802-467-3496