Organization
SCOVILLE PROSTHETICS,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY KARL SHRIEL C.P. (PRESIDENT)
(860) 247-3209
Entity
Organization
Contact information
Practice address
197 NEW BRITAIN AVE, HARTFORD, CT 06106-3124
(860) 247-3209
(860) 247-1994
Mailing address
197 NEW BRITAIN AVE, HARTFORD, CT 06106-3124
(860) 247-3209
(860) 247-1994
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12DME0481CT01
ANTHEN BC/BS OF CT.
CT
05
—
4012258
—
CT
Enumeration date
06/01/2005
Last updated
08/22/2020
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