Provider Demographics
NPI:1922288448
Name:RUTMAN'S WAYSIDE FURNITURE
Entity Type:Organization
Organization Name:RUTMAN'S WAYSIDE FURNITURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:T
Authorized Official - Last Name:EPSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:860-599-5707
Mailing Address - Street 1:88 S BROAD ST
Mailing Address - Street 2:
Mailing Address - City:PAWCATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06379-1985
Mailing Address - Country:US
Mailing Address - Phone:860-599-5707
Mailing Address - Fax:860-599-5709
Practice Address - Street 1:88 S BROAD ST
Practice Address - Street 2:
Practice Address - City:PAWCATUCK
Practice Address - State:CT
Practice Address - Zip Code:06379-1985
Practice Address - Country:US
Practice Address - Phone:860-599-5707
Practice Address - Fax:860-599-5709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2656072-000332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies