=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255862918
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CAREPOINT HOME CARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/24/2017
-----------------------------------------------------
Last Update Date | 03/24/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12986 NATIONAL RD SW UNIT C
-----------------------------------------------------
City | ETNA
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43062-7884
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-887-0478
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12986 NATIONAL RD SW UNIT C
-----------------------------------------------------
City | ETNA
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43062-7884
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-887-0478
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | SARMAN SAMAL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 678-887-0478
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------