Healthcare Provider Details

I. General information

NPI: 1831172907
Provider Name (Legal Business Name): SOUTH COUNTY HOME HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 01/06/2023
Certification Date: 01/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 WOODRUFF AVE SUITE 7
NARRAGANSETT RI
02882-3467
US

IV. Provider business mailing address

14 WOODRUFF AVE SUITE 7
NARRAGANSETT RI
02882-3467
US

V. Phone/Fax

Practice location:
  • Phone: 401-782-0500
  • Fax: 401-788-2311
Mailing address:
  • Phone: 401-782-0500
  • Fax: 401-788-2311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ANSJE GERSHKOFF
Title or Position: DIRECTOR, SOUTH COUNTY HOME HEAALTH
Credential: MBA, RN, CMC
Phone: 401-788-2330