NPIMap

Organization Active NPI

State of Connecticut Health Center

  • Durable Medical Equipment & Medical Supplies
  • Storrs Mansfield, CT
National Provider Identifier
1710156849
Registry record updated Nov 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
032452 Issued in CT
Legal business name
STATE OF CONNECTICUT HEALTH CENTER
Practice address
850 Bolton Rd
U-85
Storrs Mansfield, CT 06269-9020
Phone
(860) 486-2629
Fax
(860) 486-5422
NPI assigned
Feb 22, 2008
Last updated
Nov 20, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2013

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

Authorized official

Name
Denis C Lafreniere, MD
Title
Medical Director
Phone
(860) 679-7503

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 032452 CT Primary

Addresses

Primary practice location

850 Bolton Rd
U-85
Storrs Mansfield, CT 06269-9020

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 Other name

National Provider Directory

National Provider Directory
Tax ID family
School of Medicine28 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

Locations

850 Bolton Rd
#U85
Storrs Mansfield, CT 06269
Phone (860) 486-2629

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1203638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384905600000",
    "number": "1710156849",
    "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": "850 BOLTON RD",
            "address_2": "U-85",
            "city": "STORRS MANSFIELD",
            "state": "CT",
            "postal_code": "062699020",
            "telephone_number": "860-486-2629",
            "fax_number": "860-486-5422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF CONNECTICUT HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-22",
        "last_updated": "2013-11-20",
        "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": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CT",
            "license": "032452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Durable Medical Equipment & Medical Supplies",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Storrs Mansfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2013; 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.