Provider Demographics
NPI:1295985638
Name:COMPANION CARE OF ROCHESTER
Entity type:Organization
Organization Name:COMPANION CARE OF ROCHESTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALVIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:GAUVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-546-1600
Mailing Address - Street 1:465 BLOSSOM RD
Mailing Address - Street 2:C-1
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14610-1842
Mailing Address - Country:US
Mailing Address - Phone:585-546-1600
Mailing Address - Fax:585-546-1618
Practice Address - Street 1:465 BLOSSOM RD
Practice Address - Street 2:C-1
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14610-1842
Practice Address - Country:US
Practice Address - Phone:585-546-1600
Practice Address - Fax:585-546-1618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1517L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health