Healthcare Provider Details

I. General information

NPI: 1992777510
Provider Name (Legal Business Name): REGIONCARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 09/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 COMMUNITY DR
GREAT NECK NY
11021
US

IV. Provider business mailing address

200 COMMUNITY DR
GREAT NECK NY
11021
US

V. Phone/Fax

Practice location:
  • Phone: 516-414-3900
  • Fax: 516-414-3946
Mailing address:
  • Phone: 516-414-3900
  • Fax: 516-414-3989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number021785
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number0861L001
License Number StateNY

VIII. Authorized Official

Name: MRS. MICHELE LEE CUSACK
Title or Position: SENIOR VICE PRESIDENT AND CFO
Credential:
Phone: 516-321-6058