Provider Demographics
NPI:1558794560
Name:PROFESSIONAL MEDICAL HOMECARE LLC
Entity Type:Organization
Organization Name:PROFESSIONAL MEDICAL HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BYS
Authorized Official - Suffix:
Authorized Official - Credentials:MSN,MPA,RN,LNHA
Authorized Official - Phone:413-858-4506
Mailing Address - Street 1:265 S WESTFIELD ST
Mailing Address - Street 2:
Mailing Address - City:FEEDING HILLS
Mailing Address - State:MA
Mailing Address - Zip Code:01030-2713
Mailing Address - Country:US
Mailing Address - Phone:413-858-4506
Mailing Address - Fax:413-858-4508
Practice Address - Street 1:265 S WESTFIELD ST
Practice Address - Street 2:
Practice Address - City:FEEDING HILLS
Practice Address - State:MA
Practice Address - Zip Code:01030-2713
Practice Address - Country:US
Practice Address - Phone:413-858-4506
Practice Address - Fax:413-858-4508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-13
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8257251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health