Provider Demographics
NPI:1285639914
Name:PROFESSIONAL HOME CARE SERVICES,INC
Entity Type:Organization
Organization Name:PROFESSIONAL HOME CARE SERVICES,INC
Other - Org Name:BIOSCRIP MEDICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-879-6137
Mailing Address - Street 1:PO BOX 418711 SUITE 700
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-8711
Mailing Address - Country:US
Mailing Address - Phone:800-879-6137
Mailing Address - Fax:
Practice Address - Street 1:106 SEBETHE DR
Practice Address - Street 2:
Practice Address - City:CROMWELL
Practice Address - State:CT
Practice Address - Zip Code:06416-1094
Practice Address - Country:US
Practice Address - Phone:800-253-3738
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BIOSCRIP, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-17
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 332BP3500X
CTN/A332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTSHD.CT.0005835OtherBEDDING/UPHOLSTERED LICENSE
CTSTP.CT.0002044OtherSTERILIZATION BEDDING LICENSE
CTCSW.0000666OtherWHOLESALER LICENSE
CTDEV.0007169OtherDEVICE REGISTRATION
CT004104957Medicaid
CTSTP.CT.0002044OtherSTERILIZATION BEDDING LICENSE