| NPI | 1760480743 |
|---|---|
| Doing Business As | LIFELINE MEDICAL & DIABETIC SUPPLY |
| Entity Type | Organization |
| Authorized Contact | STEPHEN MICHEAL PUSCIZNA Manager Owner 508-646-6400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MA 1092840001) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: MA 1092840001) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MA 389254) | |
| 333600000X Pharmacy (Licence: MA 3369) | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MA 1538586) | |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2011-04-05 |