MEDICARE: CAREPROVIDERS OF BLACKSTONE VALLEY, 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	:	1871824052
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAREPROVIDERS OF BLACKSTONE VALLEY, LLC

Provider Business Mailing Address
First Line	:	176 WORCESTER PROVIDENCE TPKE
Second Line	:	SUITE 205
City	:	SUTTON
State	:	MA
Zip	:	01590-1901
Country	:	US
Telephone Number	:	508-579-9505
Fax Number	:	508-377-4578

Provider Business Practice Location Address
First Line	:	176 WORCESTER PROVIDENCE TPKE
Second Line	:	SUITE 205
City	:	SUTTON
State	:	MA
Zip	:	01590-1901
Country	:	US
Telephone Number	:	508-579-9505
Fax Number	:	508-377-4578

Authorized Official
Title or Position	:	CEO
Name	:	MR. DAVID L ROKES
Credential	:	RN
Telephone Number	:	508-579-9505

Provider Enumeration Date	:	01/27/2010
Last Update Date	:	01/17/2019

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