Organization
CHARTWELL SOUTHERN NEW ENGLAND, LLC
Active
Organization
CHARTWELL SOUTHERN NEW ENGLAND, LLC
Active
Other names
Option Care
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH BONACCORSI JD (MANAGING MEMBER)
(847) 229-7794
Entity
Organization
Contact information
Practice address
80 CLARK DR, UNITE 1-A, EAST BERLIN, CT 06023-1157
(800) 755-1511
(860) 828-0029
Mailing address
3026 PAYSPHERE CIR, CHICAGO, IL 60674-0030
(800) 879-6137
(847) 913-9024
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
1385
CT
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
1385
CT
3336C0003X
Community/Retail Pharmacy
1385
CT
3336H0001X
Home Infusion Therapy Pharmacy
Primary
1385
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004129822
—
CT
05
—
004131132
—
CT
Enumeration date
06/08/2006
Last updated
01/19/2009
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