Provider Demographics
NPI:1366499303
Name:PELTON'S INC.
Entity Type:Organization
Organization Name:PELTON'S INC.
Other - Org Name:PELTON'S HOME HEALTH CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:C
Authorized Official - Last Name:ZAMBRELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-761-0008
Mailing Address - Street 1:898 SILAS DEANE HWY
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-3412
Mailing Address - Country:US
Mailing Address - Phone:860-761-0008
Mailing Address - Fax:800-541-1723
Practice Address - Street 1:898 SILAS DEANE HWY
Practice Address - Street 2:
Practice Address - City:WETHERSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06109-3412
Practice Address - Country:US
Practice Address - Phone:860-761-0008
Practice Address - Fax:800-541-1723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
12DME0089CT02OtherBLUE CROSS PROVIDER NUMBE
CT004087632Medicaid
12DME0089CT02OtherBLUE CROSS PROVIDER NUMBE