Organization
R.P. SOUTTER ENTERPRISES, INC.
Active
Other names
HARVEST MEDICAL & SURGICAL SUPPLIES
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT P. SOUTTER CERT ORTHOTIC FITTER (PRESIDENT)
(860) 621-9166
Entity
Organization
Contact information
Practice address
461 N MAIN ST, SOUTHINGTON, CT 06489-2051
(860) 621-9166
(860) 621-9167
Mailing address
461 N MAIN ST, SOUTHINGTON, CT 06489-2051
(860) 621-9166
(860) 621-9167
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
456560
CT
335E00000X
Prosthetic/Orthotic Supplier
456560
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004068847
—
CT
01
—
0R4654
HEALTHNET
CT
01
—
12DME0264CT01
ANTHEM BLUE CROSS
CT
01
—
245161
WELLCARE
CT
Enumeration date
07/28/2006
Last updated
06/02/2011
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