1326474792 NPI number — GOOD SAMARITAN HOME CARE SOLUTIONS LLC

Table of content: (NPI 1326474792)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326474792 NPI number — GOOD SAMARITAN HOME CARE SOLUTIONS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GOOD SAMARITAN HOME CARE SOLUTIONS LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326474792
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/17/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4 RESEARCH DR
Provider Second Line Business Mailing Address:
SUITE 402
Provider Business Mailing Address City Name:
SHELTON
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06484-6280
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-691-6005
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 W SPRING ST
Provider Second Line Business Practice Location Address:
1ST FLOOR
Provider Business Practice Location Address City Name:
WEST HAVEN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06516-3338
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-691-6005
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/17/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HUBBARD
Authorized Official First Name:
ALEX
Authorized Official Middle Name:
R
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
203-691-6006

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X , with the licence number:  000806 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)