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General NPI Number Information
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NPI Number | 1558459834
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Entity Type | Organization
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Legal Business Name | LORRAINE SOUTHWORTH DBA NEW BEGINNINGS HEALTH CARE
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 11/04/2011
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Provider Practice Location Address
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Address Line | 5008 BRITTONFIELD PKWY SUITE 200
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City | EAST SYRACUSE
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State | NY
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Zip | 13057-9248
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Country | US
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Telephone | 315-634-1295
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Fax | 315-634-1296
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Provider Business Mailing Address
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Address Line | 104 VANIDA DR
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City | CAMILLUS
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State | NY
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Zip | 13031-1618
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Country | US
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Telephone | 315-487-2779
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Fax | 315-487-0461
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Authorized Official
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Title or Position | OWNER/FITTER
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Name | MRS. LORRAINE MARIE SOUTHWORTH
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Credential | REGMASECTOMYFITTER
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Telephone | 315-634-1295
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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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