Provider Demographics
NPI:1972537058
Name:MIDDLESEX HOME CARE & SUPPLIES INC
Entity Type:Organization
Organization Name:MIDDLESEX HOME CARE & SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:DRUMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:MS RPFT
Authorized Official - Phone:860-632-0393
Mailing Address - Street 1:PO BOX 375
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-0375
Mailing Address - Country:US
Mailing Address - Phone:860-632-0393
Mailing Address - Fax:860-346-9096
Practice Address - Street 1:160 WEST ST
Practice Address - Street 2:BLDG 1 SUITE K
Practice Address - City:CROMWELL
Practice Address - State:CT
Practice Address - Zip Code:06416
Practice Address - Country:US
Practice Address - Phone:860-632-0393
Practice Address - Fax:860-346-9096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT4063525Medicaid
CT12DME0164CT01OtherANTHEM BCBS
0262800001Medicare NSC