MEDICARE: CEDAR HOME HEALTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1043454663
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CEDAR HOME HEALTH LLC

Provider Business Mailing Address
First Line	:	125 SCITUATE AVE
Second Line	:
City	:	CRANSTON
State	:	RI
Zip	:	02921-1838
Country	:	US
Telephone Number	:	401-944-2100
Fax Number	:	401-944-6241

Provider Business Practice Location Address
First Line	:	125 SCITUATE AVE
Second Line	:
City	:	CRANSTON
State	:	RI
Zip	:	02921-1838
Country	:	US
Telephone Number	:	401-944-2100
Fax Number	:	401-944-6241

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. THOMAS N WHIPPLE III
Credential	:
Telephone Number	:	401-944-2100

Provider Enumeration Date	:	04/27/2009
Last Update Date	:	04/27/2009

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Directions to “CEDAR HOME HEALTH LLC ” Practice Location

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