Provider Demographics
NPI:1205311453
Name:INSULET CORPORATION
Entity type:Organization
Organization Name:INSULET CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:PETROVIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-600-7000
Mailing Address - Street 1:100 NAGOG PARK
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-3428
Mailing Address - Country:US
Mailing Address - Phone:978-600-7000
Mailing Address - Fax:
Practice Address - Street 1:155 N 400 W STE 300
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84103-1132
Practice Address - Country:US
Practice Address - Phone:801-990-2802
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INSULET CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-03
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies