Healthcare Provider Details

I. General information

NPI: 1881839918
Provider Name (Legal Business Name): IGBOBIS HEALTH CARE GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2008
Last Update Date: 12/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 FLORENCE AVE
S ATTLEBORO MA
02703-7604
US

IV. Provider business mailing address

34 FLORENCE AVE
S ATTLEBORO MA
02703-7604
US

V. Phone/Fax

Practice location:
  • Phone: 781-405-4952
  • Fax: 508-639-9142
Mailing address:
  • Phone: 781-405-4952
  • Fax: 508-639-9142

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 Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. VALENTINE N IGBOBI
Title or Position: PRESIDENT
Credential:
Phone: 781-405-4952