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Contact Information

CHARTWELL SOUTHERN NEW ENGLAND, LLC
80 CLARK DR
UNITE 1-A
EAST BERLIN, CT06023-1157
 Phone: 800-755-1511
 Fax: 860-828-0029
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Home Infusion Therapy Pharmacy

3336H0001X 58 Medical Supply Company with Pharmacist
 

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Parenteral & Enteral Nutrition

332BP3500X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for CHARTWELL SOUTHERN NEW ENGLAND, LLC

NPI # 1790725588
LBN Legal business name CHARTWELL SOUTHERN NEW ENGLAND, LLC
Authorized official JOSEPH BONACCORSI - (MANAGING MEMBER)
Entity Organization
Organization subpart 1 No
Enumeration date 06/08/2006
Last updated 01/19/2009 - About 17 years ago
Identifiers
CT License # 1385
CT Medicaid 004129822
CT Medicaid 004131132
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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