Provider Demographics
NPI:1912010653
Name:ROXSOM HOME CARE LLC
Entity Type:Organization
Organization Name:ROXSOM HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:HUSSEIN
Authorized Official - Middle Name:NUR
Authorized Official - Last Name:GULED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-529-1646
Mailing Address - Street 1:2343 WASHINGTON ST
Mailing Address - Street 2:STREET SUITE 3
Mailing Address - City:ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02119-3200
Mailing Address - Country:US
Mailing Address - Phone:617-445-7500
Mailing Address - Fax:617-445-7502
Practice Address - Street 1:2343 WASHINGTON ST
Practice Address - Street 2:STREET SUITE 3
Practice Address - City:ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02119-3200
Practice Address - Country:US
Practice Address - Phone:617-445-7500
Practice Address - Fax:617-445-7502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA000928631251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health