Provider Demographics
NPI:1275799306
Name:HEALTH COMPLEX MEDICAL, INC.
Entity Type:Organization
Organization Name:HEALTH COMPLEX MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:HOGAN
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:203-346-7526
Mailing Address - Street 1:84 PROGRESS LN
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06705-3863
Mailing Address - Country:US
Mailing Address - Phone:203-753-7778
Mailing Address - Fax:203-753-7779
Practice Address - Street 1:54 MAIN ST
Practice Address - Street 2:STE E
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-3009
Practice Address - Country:US
Practice Address - Phone:203-205-0457
Practice Address - Fax:203-207-4688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-29
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT0300170003Medicare NSC