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General NPI Number Information
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NPI Number | 1437386885
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Entity Type | Organization
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Legal Business Name | BABY BOOMER MEDICAL, INC.
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Dates
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Enumeration Date | 06/12/2009
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Last Update Date | 06/12/2009
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Provider Practice Location Address
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Address Line | 59 HERITAGE DR
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City | EAST GREENWICH
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State | RI
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Zip | 02818-2017
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Country | US
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Telephone | 401-787-3421
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Fax | 401-884-1543
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Provider Business Mailing Address
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Address Line | 59 HERITAGE DR
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City | EAST GREENWICH
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State | RI
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Zip | 02818-2017
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Country | US
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Telephone | 401-787-3421
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Fax | 401-884-1543
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSHUA EDWARD HATFIELD
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Credential | RN
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Telephone | 401-787-3421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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