Provider Demographics
NPI:1114250552
Name:SOLE REMEDY LLC
Entity Type:Organization
Organization Name:SOLE REMEDY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEANNA
Authorized Official - Middle Name:S
Authorized Official - Last Name:POLONCHEK
Authorized Official - Suffix:
Authorized Official - Credentials:CPED LATC OTSC CSCS
Authorized Official - Phone:508-295-8800
Mailing Address - Street 1:707 CRANE AVE S
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-7232
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:651 ORCHARD ST
Practice Address - Street 2:SUITE 202A
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02744-1008
Practice Address - Country:US
Practice Address - Phone:508-295-8800
Practice Address - Fax:508-880-4791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-17
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA5788400001Medicare NSC