Provider Demographics
NPI:1760530190
Name:PROCAIRE, LLC
Entity Type:Organization
Organization Name:PROCAIRE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIELMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-643-5126
Mailing Address - Street 1:PO BOX 801
Mailing Address - Street 2:
Mailing Address - City:TOLLAND
Mailing Address - State:CT
Mailing Address - Zip Code:06084-0801
Mailing Address - Country:US
Mailing Address - Phone:860-643-5126
Mailing Address - Fax:860-643-0815
Practice Address - Street 1:51 TRIANO DR
Practice Address - Street 2:
Practice Address - City:SOUTHINGTON
Practice Address - State:CT
Practice Address - Zip Code:06489-1779
Practice Address - Country:US
Practice Address - Phone:860-643-5126
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004175495Medicaid
1234510001Medicare NSC