Provider Demographics
NPI:1437599909
Name:MARJARS SOURCING INC.
Entity Type:Organization
Organization Name:MARJARS SOURCING INC.
Other - Org Name:PREMIUM HOME AIDS AND COMPANIONS SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MD
Authorized Official - Middle Name:MASUDUR
Authorized Official - Last Name:RAHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-372-4942
Mailing Address - Street 1:2264 SILAS DEANE HWY
Mailing Address - Street 2:N2
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-2333
Mailing Address - Country:US
Mailing Address - Phone:860-372-4942
Mailing Address - Fax:860-372-4992
Practice Address - Street 1:2264 SILAS DEANE HWY
Practice Address - Street 2:N2
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-2333
Practice Address - Country:US
Practice Address - Phone:860-372-4942
Practice Address - Fax:860-372-4992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-28
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTHCA0000658253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care