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General NPI Number Information
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NPI Number | 1215045125
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Entity Type | Organization
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Legal Business Name | HHC NUTRITION SERVICES LLC
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 07/26/2007
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Provider Practice Location Address
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Address Line | 2 EMILY WAY
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City | WEST HARTFORD
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State | CT
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Zip | 06107-3138
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Country | US
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Telephone | 860-561-6039
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Fax | 860-561-0480
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Provider Business Mailing Address
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Address Line | 101 SUN AVE NE COMPLIANCE DEPARTMENT
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-4373
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Country | US
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Telephone | 505-468-5604
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Fax | 505-468-4681
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Authorized Official
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Title or Position | PRESIDENT DIRECTOR
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Name | WILLIAM A MATHIS
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Credential |
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Telephone | 505-821-3355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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License Number State |
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