Organization
MERCY HOME CARE OF CONNECTICUT, INC.
Active
Other names
Mercy Cares Boutique
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HAROLD J FREDHEIM (PRESIDENT & CEO)
(203) 852-0773
Entity
Organization
Contact information
Practice address
2 LIBRARY PL, UNIT B, BETHEL, CT 06801-2106
(203) 796-0143
(203) 796-0163
Mailing address
28 KNIGHT ST, NORWALK, CT 06851-4719
(203) 852-0773
(203) 299-0415
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004180593
WELLCARE
CT
05
—
004180593
—
CT
01
—
12DME0964CT02
ANTHEM BC/BS
CT
01
—
A893738
OXFORD HEALTH PLANS
CT
Enumeration date
09/11/2008
Last updated
09/11/2008
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