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General NPI Number Information
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NPI Number | 1134243421
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Entity Type | Organization
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Legal Business Name | COMMONWEALTHMEDICALSUPPLIES
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 04/29/2008
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Provider Practice Location Address
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Address Line | 18 WATER STREET
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City | ARLINGTON
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State | MA
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Zip | 02474-4210
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Country | US
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Telephone | 781-648-1900
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Fax | 781-648-1911
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Provider Business Mailing Address
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Address Line | 18 WATER ST
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City | ARLINGTON
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State | MA
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Zip | 02476-4810
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Country | US
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Telephone | 781-648-1900
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Fax | 781-648-1911
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Authorized Official
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Title or Position | OWNER
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Name | MR. ROBERT W. MULCAHY
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Credential |
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Telephone | 781-646-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State | MA
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