Organization
VALLEY MEDICAL SUPPLY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PATRICK J SHORTELL (VICE PRESIDENT)
(203) 732-4269
Entity
Organization
Contact information
Practice address
49 PERSHING DR, DERBY, CT 06418
(203) 732-4269
(203) 732-4062
Mailing address
49 PERSHING DR, DERBY, CT 06418
(203) 732-4269
(203) 732-4062
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12DME0182CT01
ANTHEM BLUE CROSS SHEILD
—
01
—
ANC1664
OXFORD HEALTH PLANS
—
Enumeration date
09/11/2006
Last updated
08/22/2020
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