Provider Demographics
NPI: | 1053057513 |
---|---|
Name: | JUMMYOLA CARE LLC |
Entity type: | Organization |
Organization Name: | JUMMYOLA CARE LLC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER/ DIRECTOR OF OPERATIONS |
Authorized Official - Prefix: | |
Authorized Official - First Name: | OLAJUMOKE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | OLAGUNDOYE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 401-648-9146 |
Mailing Address - Street 1: | 3970 POST RD |
Mailing Address - Street 2: | |
Mailing Address - City: | WARWICK |
Mailing Address - State: | RI |
Mailing Address - Zip Code: | 02886-9235 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 401-648-9146 |
Mailing Address - Fax: | 401-735-1847 |
Practice Address - Street 1: | 3970 POST RD |
Practice Address - Street 2: | |
Practice Address - City: | WARWICK |
Practice Address - State: | RI |
Practice Address - Zip Code: | 02886-9235 |
Practice Address - Country: | US |
Practice Address - Phone: | 401-648-9146 |
Practice Address - Fax: | 401-735-1847 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2022-05-09 |
Last Update Date: | 2022-12-28 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 253Z00000X | Agencies | In Home Supportive Care | |
No | 251E00000X | Agencies | Home Health | |
No | 282J00000X | Hospitals | Religious Nonmedical Health Care Institution |