=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952268229
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEALTHSOURCE CARE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/07/2026
-----------------------------------------------------
Last Update Date | 01/07/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10 BRIDGE ST STE 7
-----------------------------------------------------
City | LOWELL
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01852-1268
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 978-427-4005
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10 BRIDGE ST STE 7
-----------------------------------------------------
City | LOWELL
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01852-1268
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 978-427-4005
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VICE PRESIDENT-NURSE
-----------------------------------------------------
Name | JOB GICHURU
-----------------------------------------------------
Credential | LPN
-----------------------------------------------------
Telephone | 978-427-4005
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 364SH0200X
-----------------------------------------------------
Taxonomy Name | Home Health Clinical Nurse Specialist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------