Provider Demographics
NPI:1770836439
Name:ROAMCARE CORPORATION
Entity Type:Organization
Organization Name:ROAMCARE CORPORATION
Other - Org Name:SYNERGY HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-542-0337
Mailing Address - Street 1:3200 4TH AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-5716
Mailing Address - Country:US
Mailing Address - Phone:619-542-0337
Mailing Address - Fax:619-862-2450
Practice Address - Street 1:3200 FOURTH AVE, SUITE 205
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-5716
Practice Address - Country:US
Practice Address - Phone:619-542-0337
Practice Address - Fax:619-862-2450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0000000Medicaid
CA0000000Medicaid