FEEL WELL HEALTH CENTER OF SOUTHINGTON, PC - NPI NUMBER 1306103502

Summary

Provider Name: FEEL WELL HEALTH CENTER OF SOUTHINGTON, PC

NPI Number: 1306103502

Clasification: Non-Pharmacy Dispensing Site (332900000X)

Address:
710 MAIN ST
BLDG 4
PLANTSVILLE, CT
ZIP 06479

Phone Number: (860) 378-2892



Detailed Information

FEEL WELL HEALTH CENTER OF SOUTHINGTON, PC is a non-pharmacy dispensing site in Plantsville, CT. The provider is a site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) The assigned NPI number for this provider is 1306103502 and is registered as an organization entity type.

The provider's business address is:

710 MAIN ST
BLDG 4
PLANTSVILLE, CT
ZIP 06479-565
Phone: (860) 378-2892

The provider's authorized official is Kevin P Greene .
The authorized official title is President and has the following contact phone number (860) 378-2892.

The enumeration date for this NPI number is 4/12/2012 and was last updated on 4/13/2012.

Map - Location of Practice

Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 332900000X Non-Pharmacy Dispensing Site Yes

NPI Record

No. Field Name Field Value
1 NPI 1306103502
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name FEEL WELL HEALTH CENTER OF SOUTHINGTON, PC
5 Provider First Line Business Practice Location Address 710 MAIN ST
6 Provider Second Line Business Practice Location Address BLDG 4
7 Provider Business Practice Location Address City Name PLANTSVILLE
8 Provider Business Practice Location Address State Name CT
9 Provider Business Practice Location Address Postal Code 064791565
10 Provider Business Practice Location Address Country Code If outside U S US
11 Provider Business Practice Location Address Telephone Number 8603782892
12 Provider Enumeration Date 4/12/2012
13 Last Update Date 4/13/2012
14 Authorized Official Last Name GREENE
15 Authorized Official First Name KEVIN
16 Authorized Official Middle Name P
17 Authorized Official Title or Position PRESIDENT
18 Authorized Official Telephone Number 8603782892
19 Healthcare Provider Taxonomy Code 1 332900000X
20 Healthcare Provider Primary Taxonomy Switch 1 Y
21 Is Organization Subpart Y
22 Parent Organization LBN FEEL WELL HEALTH CENTER OF SOUTHINGTON, PC
23 Parent Organization TIN
24 Authorized Official Name Prefix Text DR.
25 Authorized Official Credential Text MD

Download Record

Download this NPI record in Text format: Export

Download this NPI record in Excel (CSV) format: Export

Download this NPI record in XML format: Export




This page was last updated on: 10/12/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.