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General NPI Number Information
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NPI Number | 1235319260
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Entity Type | Organization
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Legal Business Name | BARE NECESSITIES OF SPRINGFIELD
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Dates
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Enumeration Date | 11/07/2007
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Last Update Date | 11/07/2007
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Provider Practice Location Address
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Address Line | 1704 BOSTON ROAD
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City | SPRINGFIELD
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State | MA
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Zip | 01129
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Country | US
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Telephone | 413-543-4642
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Fax | 413-543-1437
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Provider Business Mailing Address
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Address Line | 179-181 MEEKER AVENUE
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City | NEWARK
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State | NJ
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Zip | 07114
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Country | US
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Telephone | 973-643-2525
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Fax | 973-643-3539
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Authorized Official
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Title or Position | SR ACCOUNTANT
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Name | MR. ISRAEL MORALES
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Credential |
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Telephone | 973-643-2525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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