Provider Demographics
NPI:1225582133
Name:SAMAR HOME CARE AGENCY LLC
Entity type:Organization
Organization Name:SAMAR HOME CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:N
Authorized Official - Last Name:KIMOHU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-458-1868
Mailing Address - Street 1:75 KEELEY ST
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-6611
Mailing Address - Country:US
Mailing Address - Phone:978-996-0434
Mailing Address - Fax:
Practice Address - Street 1:75 KEELEY ST
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6611
Practice Address - Country:US
Practice Address - Phone:978-458-1868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-09
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health