Healthcare Provider Details

I. General information

NPI: 1386122042
Provider Name (Legal Business Name): NATIONWIDE HOME CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2018
Last Update Date: 07/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 CENTRAL AVE
MEDFORD MA
02155-4053
US

IV. Provider business mailing address

112 CENTRAL AVE
MEDFORD MA
02155-4053
US

V. Phone/Fax

Practice location:
  • Phone: 857-266-5345
  • Fax:
Mailing address:
  • Phone: 857-266-5345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: RONALD PIERRE
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 781-391-1002