Provider Demographics
NPI:1679724777
Name:ZIOGAS MEDICAL SUPPLIES PLUS, LLC
Entity Type:Organization
Organization Name:ZIOGAS MEDICAL SUPPLIES PLUS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIOGAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-589-9380
Mailing Address - Street 1:465 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-4994
Mailing Address - Country:US
Mailing Address - Phone:860-589-9380
Mailing Address - Fax:860-589-9395
Practice Address - Street 1:465 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-4994
Practice Address - Country:US
Practice Address - Phone:860-589-9380
Practice Address - Fax:860-589-9395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-07
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT6255860002Medicare NSC