1225468911 NPI number — GOSHEN HOMECARE AND COMPANIONS LLC

Table of content: (NPI 1225468911)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225468911 NPI number — GOSHEN HOMECARE AND COMPANIONS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GOSHEN HOMECARE AND COMPANIONS 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:
1225468911
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/18/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 174
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORWICH
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06360-0174
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-501-9526
Provider Business Mailing Address Fax Number:
860-924-2639

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
99 PIRES DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OAKDALE
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06370-1314
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-531-2420
Provider Business Practice Location Address Fax Number:
860-924-2639
Provider Enumeration Date:
11/18/2013

Additional Information

Authorized Official

Authorized Official Last Name:
ROSEME
Authorized Official First Name:
CALEB
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF CARE AND MARKETING
Authorized Official Telephone Number:
860-531-2420

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X , with the licence number:  HCA. 0000809 , 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)





Copyright © 2007-2025 www.npivalidator.com