| Doctor Name: | MR. RICHARD L THEODORE |
| NPI Number: | 1023101409 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 51103 |
| Business Practice Address: | 35 Winter St Suite 105 Hyannis, MA - 026013827 |
| Business Phone Number: | 5087713702 |
| Business Fax Number: | 5087713703 |
| Mailing Address: | 35 Winter St, Suite 105 HYANNIS |
| State: | MA |
| Postal Code: | 026013827 |
| Phone Number: | 5087713702 |
| Fax Number: | 5087713703 |
| NPI Enumeration Date: | 09/30/2006 |
| NPI Last Update Date: | 04/25/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | 51103 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MA |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |