1285713107 NPI number — CONVENIENT HOMECARE SERVICES, INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285713107 NPI number — CONVENIENT HOMECARE SERVICES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CONVENIENT HOMECARE SERVICES, INC
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:
1285713107
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/08/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
329 BOSTON POST RD UNIT A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SUDBURY
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01776-3061
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-720-9244
Provider Business Mailing Address Fax Number:
781-642-0882

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
329 BOSTON POST RD UNIT A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUDBURY
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01776-3061
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-720-9244
Provider Business Practice Location Address Fax Number:
781-642-0882
Provider Enumeration Date:
11/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ZAWEDDE
Authorized Official First Name:
JULIET
Authorized Official Middle Name:
JOSEPHINE
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
781-642-0880

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  7304 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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