Provider Demographics
NPI:1619924149
Name:M&M INDUSTRIES LLC
Entity Type:Organization
Organization Name:M&M INDUSTRIES LLC
Other - Org Name:A2Z HOME MEDICAL SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:P
Authorized Official - Last Name:MANFREDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-430-1079
Mailing Address - Street 1:162 LAKEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06073-2319
Mailing Address - Country:US
Mailing Address - Phone:860-430-1079
Mailing Address - Fax:860-430-1079
Practice Address - Street 1:15 CHESTERFIELD RD
Practice Address - Street 2:FLANDERS PLAZA
Practice Address - City:EAST LYME
Practice Address - State:CT
Practice Address - Zip Code:06333-1249
Practice Address - Country:US
Practice Address - Phone:860-739-1316
Practice Address - Fax:860-739-1320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-29
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004251980Medicaid
CT5500270001Medicare NSC