Organization
PROSPECT MANCHESTER HOSPITAL, INC.
Active
Other names
ECHN Diabetes Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT JON ELDERS (SECRETARY)
(714) 788-1249
Entity
Organization
Contact information
Practice address
2800 TAMARACK AVE STE 100, SOUTH WINDSOR, CT 06074-5553
(860) 647-6824
Mailing address
2800 TAMARACK AVE STE 100, SOUTH WINDSOR, CT 06074-5553
(860) 647-6824
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
10/08/2020
Last updated
10/08/2020
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