Connecticut Lymphatic Therapy and Supplies, LLC

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

502651 Issued in CT

Legal business name

CONNECTICUT LYMPHATIC THERAPY AND SUPPLIES, LLC

Practice address

80 Shunpike Rd Unit 101a
Cromwell, CT 06416-4402

Phone

(203) 907-7031

NPI assigned

Sep 26, 2008

Organization subpart

No

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

Authorized official

Name

Ms. Bonnie-Jean Connal

Title

Manager, CT Lymphatic

Phone

(203) 907-7031

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1222387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668038400000",
    "number": "1972753911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 SHUNPIKE RD UNIT 101A",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064164402",
            "telephone_number": "203-907-7031",
            "fax_number": "860-343-0788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 SHUNPIKE RD UNIT 101A",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064164402",
            "telephone_number": "203-907-7031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTICUT LYMPHATIC THERAPY AND SUPPLIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-26",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A",
        "authorized_official_last_name": "CONNAL",
        "authorized_official_first_name": "BONNIE-JEAN",
        "authorized_official_title_or_position": "MANAGER, CT LYMPHATIC",
        "authorized_official_telephone_number": "203-907-7031",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "CT",
            "license": "502651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT TAX ID",
            "identifier": "8950503-000",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Customized Equipment (DME) in Cromwell, CT
• Providers in Cromwell, CT by specialty
• Customized Equipment (DME) in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; 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.