# LIFE SUPPLY CORPORATIION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245453984
- **Authorized official:** JOSEPH SMITH (CEO PRESIDENT)
- **Authorized official phone:** (203) 239-1002

## Contact information

- **Practice address:** 299 CAREW ST, UNIT 134, SPRINGFIELD, MA 01104-2301
- **Practice address phone:** (413) 737-5555
- **Practice address fax:** (413) 214-7323
- **Mailing address:** 280 MOODY ST, LUDLOW, MA 01056-1244
- **Mailing address phone:** (413) 593-5555
- **Mailing address fax:** (413) 593-9530

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | MA0085173 | MA | Yes |

## Other

- **Enumeration date:** 04/11/2007
- **Last updated:** 01/24/2022