Organization
CHARTER OAK HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFERY GAGNON (FINANCIAL DIRECTOR)
(860) 550-7500
Entity
Organization
Contact information
Practice address
21 GRAND ST, HARTFORD, CT 06106-1541
(860) 550-7500
Mailing address
21 GRAND ST, HARTFORD, CT 06106-1541
(860) 550-7500
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004236015
—
CT
Enumeration date
10/08/2008
Last updated
10/08/2008
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