Provider Demographics
NPI:1336452911
Name:DME LIVING WELL, LLC
Entity type:Organization
Organization Name:DME LIVING WELL, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:M
Authorized Official - Last Name:SARAF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-674-1601
Mailing Address - Street 1:85 COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-2312
Mailing Address - Country:US
Mailing Address - Phone:860-674-1601
Mailing Address - Fax:888-897-3010
Practice Address - Street 1:85 COMMERCE ST
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-2312
Practice Address - Country:US
Practice Address - Phone:860-674-1601
Practice Address - Fax:860-955-3193
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DME LIVING WELL, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-07-23
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT6517720001Medicare NSC