Provider Demographics
NPI:1093039109
Name:EQUINOX SERVICES LLC
Entity Type:Organization
Organization Name:EQUINOX SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:A
Authorized Official - Last Name:MALLARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-416-7714
Mailing Address - Street 1:310 GEORGE WASHINGTON HWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SMITHFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02917-1957
Mailing Address - Country:US
Mailing Address - Phone:617-416-7714
Mailing Address - Fax:
Practice Address - Street 1:310 GEORGE WASHINGTON HWY
Practice Address - Street 2:SUITE 200
Practice Address - City:SMITHFIELD
Practice Address - State:RI
Practice Address - Zip Code:02917-1957
Practice Address - Country:US
Practice Address - Phone:617-416-7714
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-18
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI332BN1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies