Provider Demographics
NPI:1962657536
Name:HEALTHLOGIC LLC
Entity Type:Organization
Organization Name:HEALTHLOGIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:RASMUSSEN-FONTAINE
Authorized Official - Suffix:
Authorized Official - Credentials:CPED
Authorized Official - Phone:860-336-1732
Mailing Address - Street 1:107 PROVIDENCE ST
Mailing Address - Street 2:BELDEN MILL COMPLEX
Mailing Address - City:PUTNAM
Mailing Address - State:CT
Mailing Address - Zip Code:06260-1542
Mailing Address - Country:US
Mailing Address - Phone:860-963-7919
Mailing Address - Fax:860-963-7919
Practice Address - Street 1:107 PROVIDENCE ST
Practice Address - Street 2:BELDEN MILL COMPLEX
Practice Address - City:PUTNAM
Practice Address - State:CT
Practice Address - Zip Code:06260-1542
Practice Address - Country:US
Practice Address - Phone:860-963-7919
Practice Address - Fax:860-963-7919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-24
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies