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General NPI Number Information
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NPI Number | 1356721658
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Entity Type | Organization
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Legal Business Name | 1ST STATE ACCESSIBILITY, LLC
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Dates
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Enumeration Date | 06/02/2015
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Last Update Date | 04/03/2018
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Provider Practice Location Address
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Address Line | 105 BROOKSIDE DR
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City | WILMINGTON
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State | DE
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Zip | 19804-1103
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Country | US
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Telephone | 302-559-5652
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Fax | 844-663-4396
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Provider Business Mailing Address
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Address Line | 105 BROOKSIDE DR
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City | WILMINGTON
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State | DE
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Zip | 19804-1103
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Country | US
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Telephone | 302-559-5652
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Fax | 844-663-4396
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Authorized Official
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Title or Position | OWNER
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Name | TEAL A CONNELL
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Credential |
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Telephone | 302-559-5652
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171WH0202X
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Taxonomy Name | Home Modifications Contractor
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License Number | 2015603828
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 225CA2500X
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Taxonomy Name | Assistive Technology Supplier Rehabilitation Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 333300000X
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Taxonomy Name | Emergency Response System Companies
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License Number |
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License Number State |
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Taxonomy #5
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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 |
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