Provider Demographics
NPI:1225539018
Name:STONY RUN MEDICAL CORPORATION
Entity Type:Organization
Organization Name:STONY RUN MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICAL
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MADIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-302-7226
Mailing Address - Street 1:487 FEDERAL RD UNIT A-1
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06804-2043
Mailing Address - Country:US
Mailing Address - Phone:203-546-7153
Mailing Address - Fax:
Practice Address - Street 1:487 FEDERAL RD UNIT A-1
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-2043
Practice Address - Country:US
Practice Address - Phone:203-240-4428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-27
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies