Organization
STATE OF CONNECTICUT
Active
Other names
Durable Medical Equipment & Medical Supplies
Organization subpart
No
Provider details
NPI number
Authorized official
DENIS C LAFRENIERE M.D. (MEDICAL DIRECTOR)
(860) 679-7503
Entity
Organization
Contact information
Practice address
381 HOPMEADOW STREET, SIMSBURY, CT 06070
(860) 651-1669
(860) 658-4961
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT - DOWLING SOUTH, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
035715
CT
Other
Enumeration date
10/17/2007
Last updated
06/14/2012
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