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General NPI Number Information
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NPI Number | 1134250541
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Entity Type | Organization
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Legal Business Name | INHEALTH MED CT, PC
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 09/06/2018
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Provider Practice Location Address
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Address Line | 14 QUARRY ST
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City | WILLIMANTIC
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State | CT
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Zip | 06226
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Country | US
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Telephone | 860-423-8020
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Fax | 860-456-8288
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Provider Business Mailing Address
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Address Line | 37 IVAN HILL ST
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City | WILLIMANTIC
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State | CT
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Zip | 06226-2001
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Country | US
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Telephone | 860-423-8020
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Fax | 860-456-8288
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Authorized Official
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Title or Position | OWNER
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Name | EDMUND WEST
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Credential | MD
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Telephone | 860-423-8020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 001754
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 019026
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License Number State | CT
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