| NPI | 1295367068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK BANCROFT VYE VP Of Administration 860-972-7858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-02-10 |
| Last Update Date | 2020-02-10 |