Provider Demographics
NPI:1982718730
Name:BOYLAN HOME CARE LLC
Entity Type:Organization
Organization Name:BOYLAN HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:EMMETT
Authorized Official - Last Name:BOYLAN
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:860-963-1222
Mailing Address - Street 1:554 LIBERTY HWY
Mailing Address - Street 2:8 COLONIAL PLAZA
Mailing Address - City:PUTNAM
Mailing Address - State:CT
Mailing Address - Zip Code:06260-2728
Mailing Address - Country:US
Mailing Address - Phone:860-963-1222
Mailing Address - Fax:860-963-1107
Practice Address - Street 1:554 LIBERTY HWY
Practice Address - Street 2:8 COLONIAL PLAZA
Practice Address - City:PUTNAM
Practice Address - State:CT
Practice Address - Zip Code:06260-2728
Practice Address - Country:US
Practice Address - Phone:860-963-1222
Practice Address - Fax:860-963-1107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000784332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT12DME0795CT01OtherBCBSCT
CT205866OtherMULTIPLAN PROVIDER
CT5395410001Medicare NSC