Organization
SENIOR DEPOT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARTIN ALAN LYNCH (OWNER)
(203) 241-5113
Entity
Organization
Contact information
Practice address
195 FEDERAL RD, SUITE 2, BROOKFIELD, CT 06804-2556
(203) 775-1095
(203) 775-1098
Mailing address
195 FEDERAL RD, SUITE 2, BROOKFIELD, CT 06804-2556
(203) 775-1095
(203) 775-1098
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1055498
CT
332BN1400X
Nursing Facility Supplies (DME)
1055498
CT
332BX2000X
Oxygen Equipment & Supplies (DME)
1055498
CT
Other
Enumeration date
12/04/2015
Last updated
12/04/2015
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