Healthcare Provider Details

I. General information

NPI: 1093530693
Provider Name (Legal Business Name): GREEN PASTURES HOME AIDE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2024
Last Update Date: 11/19/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 GANSETT LN
AMAGANSETT NY
11930
US

IV. Provider business mailing address

16909 107TH AVE # 2
JAMAICA NY
11433-2420
US

V. Phone/Fax

Practice location:
  • Phone: 929-525-9594
  • Fax:
Mailing address:
  • Phone: 929-525-9594
  • 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 Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MISS DEARMO RAMSAY
Title or Position: CEO
Credential: CERT
Phone: 929-525-9594