Provider Demographics
NPI:1881268837
Name:PRONATURAL HOMECARE LLC
Entity type:Organization
Organization Name:PRONATURAL HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:OPOKU GYAMFI
Authorized Official - Suffix:
Authorized Official - Credentials:MD,ND,CSCM
Authorized Official - Phone:860-830-9796
Mailing Address - Street 1:1263 BERLIN TPKE UNIT A
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:CT
Mailing Address - Zip Code:06037-3228
Mailing Address - Country:US
Mailing Address - Phone:860-505-8995
Mailing Address - Fax:860-829-0606
Practice Address - Street 1:1263 BERLIN TPKE UNIT A
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:CT
Practice Address - Zip Code:06037-3228
Practice Address - Country:US
Practice Address - Phone:860-505-8995
Practice Address - Fax:860-829-0606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-14
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care