Healthcare Provider Details

I. General information

NPI: 1881069607
Provider Name (Legal Business Name): OCEAN STATE HOME HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2015
Last Update Date: 12/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64 AIRPORT RD
WARWICK RI
02889-1036
US

IV. Provider business mailing address

64 AIRPORT RD
WARWICK RI
02889-1036
US

V. Phone/Fax

Practice location:
  • Phone: 401-738-2560
  • Fax:
Mailing address:
  • Phone: 401-738-2560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHNC02376
License Number StateRI

VIII. Authorized Official

Name: RACHANA MAK
Title or Position: CEO
Credential: BS
Phone: 407-412-8121