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General NPI Number Information
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NPI Number | 1548359557
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Entity Type | Organization
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Legal Business Name | KIMBERLY HEALTHCARE GROUP LLC
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 133 LOUIS ST
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City | NEWINGTON
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State | CT
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Zip | 06111-4517
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Country | US
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Telephone | 860-667-9933
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Fax | 860-667-4069
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Provider Business Mailing Address
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Address Line | 17 WATERHOUSE LN
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City | CHESTER
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State | CT
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Zip | 06412-1267
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Country | US
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Telephone | 860-667-9933
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Fax | 860-667-4069
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Authorized Official
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Title or Position | OWNER
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Name | MS. BARBARA L. BOUCHARD
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Credential |
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Telephone | 860-667-9933
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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 | N/A
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License Number State |
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