Provider Demographics
NPI:1558360529
Name:HOMECARE PROFESSIONALS
Entity Type:Organization
Organization Name:HOMECARE PROFESSIONALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:F
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:AWWAD
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:203-754-1850
Mailing Address - Street 1:1587 HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06706-2403
Mailing Address - Country:US
Mailing Address - Phone:203-754-1850
Mailing Address - Fax:203-573-1308
Practice Address - Street 1:1587 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06706-2403
Practice Address - Country:US
Practice Address - Phone:203-754-1850
Practice Address - Fax:203-573-1308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT12DME0605CTOtherBLUE CROSS DME
CT713285OtherCTCARE PROVIDER NUMBER
CT898883OtherAETNA PROVIDER NUMBER
CT150OtherBLUE CROSS INFUSION PROVI
CTA782569OtherOXFORD PROVIDER NUMBER
CT1019608OtherACM PROVIDER NUMBER
CT150OtherBLUE CROSS INFUSION PROVI