MEDICARE: TWIN HARBORS MEDICAL SUPPLY

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
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1235087586
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TWIN HARBORS MEDICAL SUPPLY

Provider Business Mailing Address
First Line	:	PO BOX 1
Second Line	:
City	:	GLASTONBURY
State	:	CT
Zip	:	06033-0001
Country	:	US
Telephone Number	:	860-840-3994
Fax Number	:

Provider Business Practice Location Address
First Line	:	78 EDWIN RD
Second Line	:
City	:	SOUTH WINDSOR
State	:	CT
Zip	:	06074-2475
Country	:	US
Telephone Number	:	860-840-3994
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. PATRICK LACASSE
Credential	:
Telephone Number	:	860-840-3994

Provider Enumeration Date	:	03/20/2026
Last Update Date	:	03/20/2026

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