Organization
LIFE SUPPLY CORPORATION
Active
Other names
Diversified Medical Equipment Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH SMITH (CEO PRESIDEN)
(203) 239-1002
Entity
Organization
Contact information
Practice address
143 MILL ST, LEOMINSTER, MA 01453-3242
(978) 537-8707
(978) 537-9196
Mailing address
280 MOODY ST, LUDLOW, MA 01056-1244
(413) 593-5555
(413) 593-9530
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1544144
—
MA
Enumeration date
12/13/2006
Last updated
01/24/2022
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