Provider Demographics
NPI:1710243746
Name:POLYREMEDY, INC.
Entity Type:Organization
Organization Name:POLYREMEDY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. V.P. OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:RICHARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-318-5504
Mailing Address - Street 1:9 DAMONMILL SQUARE
Mailing Address - Street 2:SUITE 5A-1
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-2866
Mailing Address - Country:US
Mailing Address - Phone:866-609-3515
Mailing Address - Fax:978-451-0808
Practice Address - Street 1:9 DAMONMILL SQUARE
Practice Address - Street 2:SUITE 5A-1
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-2866
Practice Address - Country:US
Practice Address - Phone:866-609-3515
Practice Address - Fax:978-451-0808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56312332B00000X
DC3007503349332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies