Healthcare Provider Details

I. General information

NPI: 1851036651
Provider Name (Legal Business Name): MCCOY FAMILY ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2022
Last Update Date: 05/26/2022
Certification Date: 05/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 N MAIN ST
SUFFIELD CT
06078-2164
US

IV. Provider business mailing address

66 N MAIN ST
SUFFIELD CT
06078-2164
US

V. Phone/Fax

Practice location:
  • Phone: 860-758-7600
  • Fax: 860-758-7602
Mailing address:
  • Phone: 860-758-7600
  • Fax: 860-758-7602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DANIEL P MCCOY
Title or Position: PRESIDENT
Credential:
Phone: 860-758-7600