NPIMap

Organization Active NPI

State of Connecticut

  • Durable Medical Equipment & Medical Supplies
  • Avon, CT
National Provider Identifier
1164601183
Registry record updated Jun 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
035715 Issued in CT
Legal business name
STATE OF CONNECTICUT
Practice address
2 Simsbury Rd
C/O Roy Beebe, MD
Avon, CT 06001-3711
Phone
(860) 678-0022
Fax
(860) 679-1610
NPI assigned
Oct 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2012

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

Authorized official

Name
Denis C Lafreniere, M.D.
Title
Medical Director
Phone
(860) 679-7503

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 035715 CT Primary

Addresses

Primary practice location

2 Simsbury Rd
C/O Roy Beebe, MD
Avon, CT 06001-3711

Mailing address

263 Farmington Ave
Provider Enrollment - Dowling South
Farmington, CT 06030-2212
Phone (860) 679-7503

Other names 1

  • Durable Medical Equipment & Medical Supplies Doing business as

National Provider Directory

National Provider Directory
Tax ID family
University of Connecticut28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339632000000",
    "number": "1164601183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "address_2": "PROVIDER ENROLLMENT - DOWLING SOUTH",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060302212",
            "telephone_number": "860-679-7503",
            "fax_number": "860-679-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SIMSBURY RD",
            "address_2": "C/O ROY BEEBE, MD",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013711",
            "telephone_number": "860-678-0022",
            "fax_number": "860-679-1610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF CONNECTICUT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-26",
        "last_updated": "2012-06-14",
        "status": "A",
        "authorized_official_last_name": "LAFRENIERE",
        "authorized_official_first_name": "DENIS",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "860-679-7503",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CT",
            "license": "035715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Durable Medical Equipment & Medical Supplies",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Avon, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2012; 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.