=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124319686
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RITE CHOICE HOME CAREAGENCY, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/02/2011
-----------------------------------------------------
Last Update Date | 05/02/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11655 QUEENS BLVD STE 214
-----------------------------------------------------
City | FOREST HILLS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11375-6527
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-261-2700
-----------------------------------------------------
Fax | 718-261-2735
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11655 QUEENS BLVD STE 214
-----------------------------------------------------
City | FOREST HILLS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11375-6527
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-261-2700
-----------------------------------------------------
Fax | 718-261-2735
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | MR. OLEG PINKHASOV
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 718-261-2700
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 1589L001
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------