Provider Demographics
NPI:1861439655
Name:PHYSICIANS HOMECARELLC
Entity Type:Organization
Organization Name:PHYSICIANS HOMECARELLC
Other - Org Name:PHYSICIANS HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:TALBOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-930-3500
Mailing Address - Street 1:2 ADAMS PL
Mailing Address - Street 2:SUITE 405
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-7456
Mailing Address - Country:US
Mailing Address - Phone:781-930-3500
Mailing Address - Fax:781-930-3570
Practice Address - Street 1:651 ORCHARD ST
Practice Address - Street 2:SUITE 300
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02744-1008
Practice Address - Country:US
Practice Address - Phone:508-994-3433
Practice Address - Fax:508-994-5420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2007-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0600075Medicaid
MA002113OtherSENIOR WHOLE HEALTH
MA002115OtherSENIOR WHOLE HEALTH
MA0025129OtherNEIGHBORHOOD HEALTH PLAN
MA697145OtherTUFTS HEALTH PLAN
MA000000023561OtherBOSTON MEDICAL CENTER HEA
MA002114OtherSENIOR WHOLE HEALTH
MA1028506OtherACM/UNITE HEALTH CARE
227473Medicare ID - Type Unspecified