Provider Demographics
NPI:1700247517
Name:SPEEDRAIN ENTERPRISES LLC
Entity Type:Organization
Organization Name:SPEEDRAIN ENTERPRISES LLC
Other - Org Name:ON THE MEND MEDICAL SUPPLIES & EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LIAM
Authorized Official - Middle Name:GERARD
Authorized Official - Last Name:OKEEFFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-510-9230
Mailing Address - Street 1:385 MAIN ST S STE 102
Mailing Address - Street 2:
Mailing Address - City:SOUTHBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06488-4244
Mailing Address - Country:US
Mailing Address - Phone:203-510-9230
Mailing Address - Fax:
Practice Address - Street 1:385 MAIN ST S STE 102
Practice Address - Street 2:
Practice Address - City:SOUTHBURY
Practice Address - State:CT
Practice Address - Zip Code:06488-4244
Practice Address - Country:US
Practice Address - Phone:203-510-9230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-08
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1199667332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies