Provider Demographics
NPI:1134420334
Name:SCOVIN HOME CARE
Entity type:Organization
Organization Name:SCOVIN HOME CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:J
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:RADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-767-2500
Mailing Address - Street 1:68 CUMBERLAND ST
Mailing Address - Street 2:SUITE 303
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-3323
Mailing Address - Country:US
Mailing Address - Phone:401-767-2500
Mailing Address - Fax:401-767-2501
Practice Address - Street 1:68 CUMBERLAND ST
Practice Address - Street 2:SUITE 303
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-3323
Practice Address - Country:US
Practice Address - Phone:401-767-2500
Practice Address - Fax:401-767-2501
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SCOVIN INTERESTS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-11-04
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIHNC02352251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health