Provider Demographics
NPI:1972265205
Name:DME LIVING WELL, LLC
Entity Type:Organization
Organization Name:DME LIVING WELL, LLC
Other - Org Name:DME LIVING WELL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARAF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-674-1601
Mailing Address - Street 1:85 COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-2312
Mailing Address - Country:US
Mailing Address - Phone:860-674-1601
Mailing Address - Fax:508-409-3658
Practice Address - Street 1:484 MAIN ST
Practice Address - Street 2:
Practice Address - City:FISKDALE
Practice Address - State:MA
Practice Address - Zip Code:01518-1302
Practice Address - Country:US
Practice Address - Phone:508-682-5661
Practice Address - Fax:508-409-3658
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DME LIVING WELL, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-10-13
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier