Provider Demographics
NPI:1306421557
Name:BEDSIDE HOME CARE SERVICES LLC
Entity type:Organization
Organization Name:BEDSIDE HOME CARE SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:774-381-2435
Mailing Address - Street 1:7A ALLARD CT
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NH
Mailing Address - Zip Code:03051-6904
Mailing Address - Country:US
Mailing Address - Phone:774-381-4253
Mailing Address - Fax:
Practice Address - Street 1:188 CENTRAL ST STE 3
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NH
Practice Address - Zip Code:03051-4499
Practice Address - Country:US
Practice Address - Phone:774-381-4253
Practice Address - Fax:603-521-7652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-09
Last Update Date:2021-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH1306421557Medicaid
NH04462Medicaid