=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679702989
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DEBORAH TWOMEY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/08/2009
-----------------------------------------------------
Last Update Date | 07/08/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 315 BLANCHARD ROAD EXT
-----------------------------------------------------
City | CUMBERLAND
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04021-3208
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-829-6625
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 315 BLANCHARD ROAD EXT
-----------------------------------------------------
City | CUMBERLAND
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04021-3208
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DEBORAH TWOMEY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 207-829-6625
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------