Provider Demographics
NPI:1225198443
Name:CARNEY MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:CARNEY MEDICAL SUPPLY INC
Other - Org Name:CARNEY MEDICAL SUPPLY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:KEEFE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:603-534-0866
Mailing Address - Street 1:32 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03867-1905
Mailing Address - Country:US
Mailing Address - Phone:603-332-5638
Mailing Address - Fax:603-332-2137
Practice Address - Street 1:32 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-1905
Practice Address - Country:US
Practice Address - Phone:603-332-5638
Practice Address - Fax:603-332-2137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30763892Medicaid
NH30763892Medicaid
NH1225198443Medicare NSC