Organization
NORTHEAST PEDORTHICS AND DME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID CHANDONNET C PED (PRINCIPLE MANAGER)
(401) 383-4466
Entity
Organization
Contact information
Practice address
999 WARWICK AVE, WARWICK, RI 02888-3646
(401) 383-4466
(401) 383-4598
Mailing address
999 WARWICK AVE, WARWICK, RI 02888-3646
(401) 383-4466
(401) 383-4598
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30762477
—
NH
05
—
3740001
—
RI
Enumeration date
12/15/2006
Last updated
04/20/2011
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