1891098349 NPI number — PARA PHARM, INC

Table of content: (NPI 1891098349)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891098349 NPI number — PARA PHARM, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PARA PHARM, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
PUTNAM HOME MEDICAL
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891098349
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/23/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1213 MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILLIMANTIC
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06226-1907
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-423-1661
Provider Business Mailing Address Fax Number:
860-423-4334

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
37 KENNEDY DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PUTNAM
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06260-1946
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-963-7007
Provider Business Practice Location Address Fax Number:
860-963-7030
Provider Enumeration Date:
12/06/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WOJNAR
Authorized Official First Name:
JASON
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF HME
Authorized Official Telephone Number:
860-423-1661

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)