Provider Demographics
NPI:1104222314
Name:REGIONAL HOME CARE INC
Entity Type:Organization
Organization Name:REGIONAL HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:BROCKMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-840-0113
Mailing Address - Street 1:125 TOLMAN AVE
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-1912
Mailing Address - Country:US
Mailing Address - Phone:978-840-0113
Mailing Address - Fax:978-840-0115
Practice Address - Street 1:559 UNION ST
Practice Address - Street 2:#2
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3705
Practice Address - Country:US
Practice Address - Phone:207-123-4567
Practice Address - Fax:978-840-0115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-16
Last Update Date:2014-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies