1417082835 NPI number — MS. WENDY SCUTT HOME HEALTH AIDE

Table of content: MS. WENDY SCUTT HOME HEALTH AIDE (NPI 1417082835)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417082835 NPI number — MS. WENDY SCUTT HOME HEALTH AIDE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCUTT
Provider First Name:
WENDY
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
HOME HEALTH AIDE
Provider Gender Code:
F

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:
1417082835
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8 PENIKESE ST
Provider Second Line Business Mailing Address:
P.O. BOX 724
Provider Business Mailing Address City Name:
WEST WAREHAM
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02576-1108
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-743-7838
Provider Business Mailing Address Fax Number:
508-743-7031

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8 PENIKESE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST WAREHAM
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02576-1108
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-743-7838
Provider Business Practice Location Address Fax Number:
508-743-7031
Provider Enumeration Date:
02/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 374U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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