Organization
MMI SCRIPT HUB & MEDICAL SUPPLIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICKY MCCULLOUGH (CEO)
(860) 477-0961
Entity
Organization
Contact information
Practice address
1768 STORRS RD, STORRS, CT 06268-1260
(860) 477-0961
(860) 477-0962
Mailing address
48A MOOSUP VALLEY ROAD, FOSTER, RI 02825-1236
(401) 397-6203
(401) 397-8559
Taxonomy
Speciality
Code
Description
License number
State
125Q00000X
Oral Medicine Dentistry
—
—
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
52697
MA
207R00000X
Internal Medicine Physician
MD06257
RI
207RX0202X
Medical Oncology Physician
—
—
207VX0201X
Gynecologic Oncology Physician
—
—
2085R0001X
Radiation Oncology Physician
—
—
208D00000X
General Practice Physician
Primary
MD06257
RI
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
10/28/2015
Last updated
04/17/2018
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