Waterbury Medical Equip Supply Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

WATERBURY MEDICAL EQUIP SUPPLY INC

Practice address

1395 Baldwin St
Waterbury, CT 06706-2002

Phone

(203) 754-4118

Fax

(203) 756-3829

NPI assigned

Aug 3, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. David S Shea

Title

Owner

Phone

(203) 754-4118

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264550400000",
    "number": "1114934775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 BALDWIN STREET",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "06706",
            "telephone_number": "203-754-4118",
            "fax_number": "203-756-3829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 BALDWIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067062002",
            "telephone_number": "203-754-4118",
            "fax_number": "203-756-3829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERBURY MEDICAL EQUIP SUPPLY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2010-01-27",
        "status": "A",
        "authorized_official_last_name": "SHEA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-754-4118",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004020665",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Durable Medical Equipment & Medical Supplies in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.