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NPI Code Detail

MEDICARE: WILLIAM GRENNON HHA, CNA, PCA

MEDICARE: WILLIAM GRENNON HHA, CNA, PCA
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
1372500000XChore Provider
2372600000XAdult Companion
3373H00000XDay Training/Habilitation Specialist
43747A0650XAttendant Care Provider
53747P1801XPersonal Care Attendant
6374U00000XHome Health Aide
7376G00000XNursing Home Administrator
8376J00000XHomemaker
9376K00000XNurse's Aide

General Provider Information

NPI Number : 1487092318
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM GRENNON HHA, CNA, PCA
Provider Business Mailing Address
First Line : PO BOX 315
Second Line :
City : GLOUCESTER
State : MA
Zip : 01931-0315
Country : US
Telephone Number : 978-412-5440
Fax Number :
Provider Business Practice Location Address
First Line : 424 HEIGHTS AT CAPE ANN
Second Line :
City : GLOUCESTER
State : MA
Zip : 01930-5341
Country : US
Telephone Number : 978-412-5440
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2013
Last Update Date : 06/13/2013

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