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General NPI Number Information
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NPI Number | 1134420334
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Entity Type | Organization
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Legal Business Name | SCOVIN HOME CARE
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Dates
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Enumeration Date | 11/04/2010
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Last Update Date | 11/04/2010
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Provider Practice Location Address
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Address Line | 68 CUMBERLAND ST SUITE 303
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City | WOONSOCKET
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State | RI
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Zip | 02895-3323
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Country | US
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Telephone | 401-767-2500
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Fax | 401-767-2501
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Provider Business Mailing Address
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Address Line | 68 CUMBERLAND ST SUITE 303
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City | WOONSOCKET
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State | RI
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Zip | 02895-3323
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Country | US
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Telephone | 401-767-2500
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Fax | 401-767-2501
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. J SCOTT RADLEY
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Credential |
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Telephone | 401-767-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HNC02352
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License Number State | RI
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