Provider Demographics
NPI:1255026183
Name:BLUE HILL MEDICAL SUPPLY
Entity type:Organization
Organization Name:BLUE HILL MEDICAL SUPPLY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISHNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GIDWANI
Authorized Official - Suffix:
Authorized Official - Credentials:COF,DMEC
Authorized Official - Phone:888-202-9936
Mailing Address - Street 1:1600 BOSTON PROVIDENCE HWY
Mailing Address - Street 2:SUITE 213
Mailing Address - City:WALPOLE
Mailing Address - State:MA
Mailing Address - Zip Code:02081
Mailing Address - Country:US
Mailing Address - Phone:321-402-6716
Mailing Address - Fax:508-819-4989
Practice Address - Street 1:1600 BOSTON PROVIDENCE HWY
Practice Address - Street 2:SUITE 213
Practice Address - City:WALPOLE
Practice Address - State:MA
Practice Address - Zip Code:02081
Practice Address - Country:US
Practice Address - Phone:321-402-6716
Practice Address - Fax:508-819-4989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-06
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies