Provider Demographics
NPI:1952797524
Name:ORAL HEALTHCARE@HOME, INC.
Entity Type:Organization
Organization Name:ORAL HEALTHCARE@HOME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FITZGERALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-493-4723
Mailing Address - Street 1:497 HOOKSETT RD
Mailing Address - Street 2:#166
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-2632
Mailing Address - Country:US
Mailing Address - Phone:603-493-4723
Mailing Address - Fax:
Practice Address - Street 1:497 HOOKSETT RD
Practice Address - Street 2:#166
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-2632
Practice Address - Country:US
Practice Address - Phone:603-493-4723
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-10
Last Update Date:2015-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health