STATE OF CONNECTICUT

AVON, CT
NPI1164601183
Doing Business AsDURABLE MEDICAL EQUIPMENT & MEDICAL SUPPLIES
Entity TypeOrganization
Authorized ContactDENIS C LAFRENIERE
Medical Director
860-679-7503
Organization Subpart ?No
Primary Taxonomy332B00000X Durable Medical Equipment & Medical Supplies
(Licence: CT  035715)
Enumeration Date2007-10-26
Last Update Date2012-06-14
Business Address
STATE OF CONNECTICUT
2 SIMSBURY RD C/O ROY BEEBE, MD
AVON, CT 06001-3711
Phone number: 860-678-0022
Mailing Address
STATE OF CONNECTICUT
263 FARMINGTON AVE PROVIDER ENROLLMENT - DOWLING SOUTH
FARMINGTON, CT 06030-2212
Phone number: 860-679-7503
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