Provider Demographics
NPI:1003857988
Name:ACCESSIBLE HOME MEDICAL SUPPLIES, LLC
Entity Type:Organization
Organization Name:ACCESSIBLE HOME MEDICAL SUPPLIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:T
Authorized Official - Last Name:GABRIELLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-726-9600
Mailing Address - Street 1:12B MOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-2339
Mailing Address - Country:US
Mailing Address - Phone:860-726-9600
Mailing Address - Fax:860-726-9601
Practice Address - Street 1:12B MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-2339
Practice Address - Country:US
Practice Address - Phone:860-726-9600
Practice Address - Fax:860-726-9601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT5559810001Medicare ID - Type Unspecified