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General NPI Number Information
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NPI Number | 1649097791
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Entity Type | Organization
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Legal Business Name | INFOM HEALTHCARE AGENCY
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Dates
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Enumeration Date | 09/20/2024
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 1 AMANDA WAY
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City | PROVIDENCE
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State | RI
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Zip | 02904-1069
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Country | US
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Telephone | 401-516-0937
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Fax |
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Provider Business Mailing Address
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Address Line | 1 AMANDA WAY
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City | PROVIDENCE
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State | RI
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Zip | 02904-1069
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Country | US
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Telephone | 401-516-0937
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Fax |
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Authorized Official
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Title or Position | NURSE
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Name | OLUWAFUNKE JOSEPHINE ISHIOYE
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Credential | REGISTERED NURSE
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Telephone | 401-516-0937
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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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