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General NPI Number Information
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NPI Number | 1790979201
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Entity Type | Organization
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Legal Business Name | STRIDE MEDICAL INC
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Dates
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Enumeration Date | 08/29/2007
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Last Update Date | 03/25/2009
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Provider Practice Location Address
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Address Line | 291 CUMMINS HIGHWAY
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City | ROSLINDALE
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State | MA
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Zip | 02131-3843
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Country | US
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Telephone | 617-469-3574
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Fax |
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Provider Business Mailing Address
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Address Line | 291 CUMMINS HWY
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City | ROSLINDALE
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State | MA
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Zip | 02131-3843
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Country | US
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Telephone | 617-469-3574
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. OSAZEE WOGHIREN
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Credential |
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Telephone | 617-469-3574
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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 | 000914053
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License Number State | MA
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