1518054451 NPI number — COMMUNITY NURSE HOME CARE, INC.

Table of content: (NPI 1518054451)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518054451 NPI number — COMMUNITY NURSE HOME CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMMUNITY NURSE HOME CARE, 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:
1518054451
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/23/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
62 CENTER STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FAIRHAVEN
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02719-3823
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-992-6278
Provider Business Mailing Address Fax Number:
508-996-0781

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
62 CENTER STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAIRHAVEN
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02719-3823
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-992-6278
Provider Business Practice Location Address Fax Number:
508-996-0781
Provider Enumeration Date:
10/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PARENT
Authorized Official First Name:
LISA
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
508-992-6278

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X , with the licence number:  7234 , 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)

  • Identifier: 0605697 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 806021 . This is a "TUFTS HOSPICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0007801 . This is a "NHP HOSPICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 701044 . This is a "HCHP HOSPICE" identifier . This identifiers is of the category "OTHER".




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