Healthcare Provider Details

I. General information

NPI: 1699164558
Provider Name (Legal Business Name): HUDUMA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2015
Last Update Date: 01/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

390 MAIN ST STE 1041
WORCESTER MA
01608-2583
US

IV. Provider business mailing address

390 MAIN ST STE 1041
WORCESTER MA
01608-2583
US

V. Phone/Fax

Practice location:
  • Phone: 508-826-5387
  • Fax: 508-754-8272
Mailing address:
  • Phone: 508-826-5387
  • Fax: 508-754-8272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number452784552
License Number StateMA

VII. Legacy identifiers

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

VIII. Authorized Official

Name: MR. EDWIN GICHUHI GITHIACA
Title or Position: PRESIDENT
Credential:
Phone: 508-826-5387