| NPI | 1811020209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN PANE Owner 860-283-6248 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition | |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2015-08-07 |