Provider Demographics
NPI:1013368539
Name:COG HOME HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:COG HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF HOME HEALTH SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:T
Authorized Official - Last Name:JEROME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:340-779-2663
Mailing Address - Street 1:9151 ESTATE THOMAS
Mailing Address - Street 2:FOOTHILLS PROFESSIONAL BUILDING SUITE 206
Mailing Address - City:ST. THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00802-4567
Mailing Address - Country:US
Mailing Address - Phone:340-779-4663
Mailing Address - Fax:340-779-2443
Practice Address - Street 1:9151 ESTATE THOMAS
Practice Address - Street 2:FOOTHILLS PROFESSIONAL BUILDING SUITE 206
Practice Address - City:ST. THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-4567
Practice Address - Country:US
Practice Address - Phone:340-779-2663
Practice Address - Fax:340-779-2443
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPREHENSIVE ORTHOPEDICS PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-06-27
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health