Healthcare Provider Details

I. General information

NPI: 1851987614
Provider Name (Legal Business Name): P& N VISION HEALTH CARE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2020
Last Update Date: 12/16/2020
Certification Date: 12/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 LONGFELLOW RD
WORCESTER MA
01602-2715
US

IV. Provider business mailing address

15 LONGFELLOW RD
WORCESTER MA
01602-2715
US

V. Phone/Fax

Practice location:
  • Phone: 508-250-8378
  • Fax:
Mailing address:
  • Phone:
  • 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 Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: AMIDA NCHAW
Title or Position: OWNER
Credential:
Phone: 508-250-8378