Provider Demographics
NPI:1093075665
Name:SOUTH SHORE HOMECARE INC.
Entity Type:Organization
Organization Name:SOUTH SHORE HOMECARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:OBIOMA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALAMBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-230-8683
Mailing Address - Street 1:859 WILLARD ST STE 400
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-7469
Mailing Address - Country:US
Mailing Address - Phone:617-934-1682
Mailing Address - Fax:617-934-1686
Practice Address - Street 1:859 WILLARD ST STE 400
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-7469
Practice Address - Country:US
Practice Address - Phone:617-934-1682
Practice Address - Fax:617-934-1686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-17
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110103385Medicaid