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General NPI Number Information
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NPI Number | 1790090553
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Entity Type | Organization
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Legal Business Name | CODE ONE MEDICAL SOLUTIONS, LLC
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Dates
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Enumeration Date | 08/17/2010
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Last Update Date | 08/17/2010
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Provider Practice Location Address
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Address Line | 27 MEADOW ST FLOOR 2
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City | WILLIMANTIC
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State | CT
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Zip | 06226-2506
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Country | US
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Telephone | 860-786-1789
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Fax | 888-427-7448
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Provider Business Mailing Address
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Address Line | 27 MEADOW ST FLOOR 2
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City | WILLIMANTIC
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State | CT
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Zip | 06226-2506
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Country | US
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Telephone | 860-786-1789
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Fax | 888-427-7448
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Authorized Official
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Title or Position | OWNER
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Name | MR. RICHARD C SHOK
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Credential | RN, BSN, EMS-I
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Telephone | 860-786-1789
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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