Provider Demographics
NPI:1497112585
Name:BEE WELL HOUSE CALLS, LLC
Entity Type:Organization
Organization Name:BEE WELL HOUSE CALLS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COOWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:PELOSI
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:203-525-8052
Mailing Address - Street 1:23 PEACH DR
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:CT
Mailing Address - Zip Code:06483-2013
Mailing Address - Country:US
Mailing Address - Phone:203-525-8052
Mailing Address - Fax:
Practice Address - Street 1:21 CHURCH ST
Practice Address - Street 2:
Practice Address - City:NAUGATUCK
Practice Address - State:CT
Practice Address - Zip Code:06770-4111
Practice Address - Country:US
Practice Address - Phone:203-525-8052
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-21
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005149363LF0000X
CT12004866363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT=========OtherEIN