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General NPI Number Information
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NPI Number | 1205869575
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Entity Type | Organization
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Legal Business Name | PRIMARY HOMECARE SPECIALTIES, LLC
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 06/12/2009
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Provider Practice Location Address
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Address Line | 75 ADAMS ST SUITE D
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City | MILTON
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State | MA
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Zip | 02186-3432
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Country | US
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Telephone | 617-696-0600
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Fax | 617-696-1200
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Provider Business Mailing Address
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Address Line | 75 ADAMS ST SUITE D
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City | MILTON
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State | MA
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Zip | 02186-3432
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Country | US
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Telephone | 617-696-0600
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Fax | 617-696-1200
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Authorized Official
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Title or Position | DIRECTOR/MANAGER
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Name | MRS. CELESTE CEFALU
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Credential | R.N.
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Telephone | 617-930-7076
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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 |
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License Number State |
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