Provider Demographics
NPI:1639955727
Name:MIDIA HOME HEALTHCARE
Entity Type:Organization
Organization Name:MIDIA HOME HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADDO-AIKINS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:508-523-4274
Mailing Address - Street 1:5 SENECA ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01603-2218
Mailing Address - Country:US
Mailing Address - Phone:508-523-4274
Mailing Address - Fax:
Practice Address - Street 1:5 SENECA ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01603-2218
Practice Address - Country:US
Practice Address - Phone:508-523-4274
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-05
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health