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Organization
PROSPECT MANCHESTER HOSPITAL, INC.
Active
Organization
PROSPECT MANCHESTER HOSPITAL, INC.
Active
Other names
ECHN Diabetes Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT JON ELDERS (SECRETARY)
(714) 788-1249
Entity
Organization
Contact information
Practice address
2800 TAMARACK AVE STE 100, SOUTH WINDSOR, CT 06074-5553
(860) 647-6824
Mailing address
2800 TAMARACK AVE STE 100, SOUTH WINDSOR, CT 06074-5553
(860) 647-6824
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
NULL
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
10/08/2020
Last updated
10/08/2020
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