Organization
DEBORAH A. CANNEY
Active
Other names
Canney Medical Supply, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY MARVIN PETERSEN PEDORTHIST (MANAGER)
(763) 607-6874
Entity
Organization
Contact information
Practice address
152 FRONT ST, EXETER, NH 03833-2329
(603) 580-2949
(267) 350-9184
Mailing address
152 FRONT ST, EXETER, NH 03833-2329
(603) 580-2949
(267) 350-9184
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1540271
—
MA
05
—
30761514
—
NH
01
—
705068
HARVARD PILGRIM HEALTH CA
—
Enumeration date
08/20/2006
Last updated
08/07/2012
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