Organization
SHORELINE MEDICAL EQUIPMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRENDON PETER O'BRIEN (OWNER)
(203) 488-0303
Entity
Organization
Contact information
Practice address
59 SCHOOL GROUND RD, UNIT# 5, BRANFORD, CT 06405-2868
(203) 488-0303
(203) 488-0606
Mailing address
59 SCHOOL GROUND RD, UNIT# 5, BRANFORD, CT 06405-2868
(203) 488-0303
(203) 488-0606
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
CSW.0001502
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004245529
—
CT
01
—
1978105-000
STATE OF CT TAX ID#
CT
Enumeration date
08/19/2005
Last updated
08/01/2012
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