Provider Demographics
NPI:1154663094
Name:SULLY HOME CARE SERVICES INC
Entity type:Organization
Organization Name:SULLY HOME CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:OSMAN
Authorized Official - Middle Name:ERMANN
Authorized Official - Last Name:SULLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-510-6963
Mailing Address - Street 1:145 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-2729
Mailing Address - Country:US
Mailing Address - Phone:617-212-6527
Mailing Address - Fax:781-885-7483
Practice Address - Street 1:29 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:MA
Practice Address - Zip Code:02322-1918
Practice Address - Country:US
Practice Address - Phone:617-212-6527
Practice Address - Fax:781-885-7483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-19
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based