Healthcare Provider Details

I. General information

NPI: 1538704200
Provider Name (Legal Business Name): CONCORDIA HOME CARE AND NURSING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2019
Last Update Date: 11/07/2022
Certification Date: 11/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 HAMPDEN DR STE 1
EASTON MA
02375-1180
US

IV. Provider business mailing address

20 HAMPDEN DR STE 1
EASTON MA
02375-1180
US

V. Phone/Fax

Practice location:
  • Phone: 177-429-6807
  • Fax:
Mailing address:
  • Phone: 774-296-8072
  • Fax: 774-220-8775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DAPHNEY SIMON-PASCAL
Title or Position: AUTHORIZED AGENT
Credential: RN
Phone: 781-588-0687