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General NPI Number Information
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NPI Number | 1700063682
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Entity Type | Organization
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Legal Business Name | COPIHUE CORP
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Dates
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Enumeration Date | 01/23/2008
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Last Update Date | 01/23/2008
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Provider Practice Location Address
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Address Line | 1345 JEFFERSON BLVD SUITE 1W
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City | WARWICK
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State | RI
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Zip | 02886-2500
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Country | US
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Telephone | 401-384-6485
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Fax | 401-384-6487
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Provider Business Mailing Address
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Address Line | 1345 JEFFERSON BLVD SUITE 1W
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City | WARWICK
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State | RI
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Zip | 02886-2202
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Country | US
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Telephone | 401-384-6485
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Fax | 401-384-6487
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSEPH PADUCH
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Credential |
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Telephone | 401-384-6485
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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 | HCP02443
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License Number State | RI
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