Provider Demographics
NPI:1619276193
Name:EQUINOX SERVICES
Entity Type:Organization
Organization Name:EQUINOX SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:MR
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:
Authorized Official - Last Name:LEDGERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-349-9450
Mailing Address - Street 1:300 GEORGE WASHINGTON HWY
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02917-1918
Mailing Address - Country:US
Mailing Address - Phone:401-349-9450
Mailing Address - Fax:
Practice Address - Street 1:300 GEORGE WASHINGTON HWY
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:RI
Practice Address - Zip Code:02917-1918
Practice Address - Country:US
Practice Address - Phone:401-349-9450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-23
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies