Provider Demographics
NPI:1427720622
Name:SUZZAN'S IMPORTS AND EXPORTS GENERAL GOODS AND SERVICES LLC
Entity type:Organization
Organization Name:SUZZAN'S IMPORTS AND EXPORTS GENERAL GOODS AND SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHARMAINE
Authorized Official - Middle Name:DIANNA
Authorized Official - Last Name:BALFOUR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:860-725-2842
Mailing Address - Street 1:515 ELLIS ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06051-3729
Mailing Address - Country:US
Mailing Address - Phone:860-725-2842
Mailing Address - Fax:
Practice Address - Street 1:515 ELLIS ST
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06051-3729
Practice Address - Country:US
Practice Address - Phone:860-725-2842
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health