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NPI Code Detail

MEDICARE: NORTHWEST MEDICAL SUPPLY, LLC

MEDICARE: NORTHWEST MEDICAL SUPPLY, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies0003954326CT

General Provider Information

NPI Number : 1013147891
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTHWEST MEDICAL SUPPLY, LLC
Provider Business Mailing Address
First Line : 10 MARINE ST
Second Line :
City : THOMASTON
State : CT
Zip : 06787-1470
Country : US
Telephone Number : 860-283-2839
Fax Number : 860-283-9468
Provider Business Practice Location Address
First Line : 10 MARINE ST
Second Line :
City : THOMASTON
State : CT
Zip : 06787-1470
Country : US
Telephone Number : 860-283-2839
Fax Number : 860-283-9468
Authorized Official
Title or Position : MANAGING MEMBER
Name : THOMAS J. BATISTE
Credential :
Telephone Number : 860-283-2839
Provider Enumeration Date : 07/15/2009
Last Update Date : 07/15/2009

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Directions to “NORTHWEST MEDICAL SUPPLY, LLC ” Practice Location

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