Provider Demographics
NPI:1053705277
Name:HOMECARE SOFTWARE SOLUTIONS LLC.
Entity type:Organization
Organization Name:HOMECARE SOFTWARE SOLUTIONS LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FISCAL SERVICE SYSTEMS, MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHNY
Authorized Official - Middle Name:
Authorized Official - Last Name:JEROME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-407-4633
Mailing Address - Street 1:3640 37TH ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-1638
Mailing Address - Country:US
Mailing Address - Phone:718-407-4633
Mailing Address - Fax:
Practice Address - Street 1:3640 37TH ST
Practice Address - Street 2:SUITE 203
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-1638
Practice Address - Country:US
Practice Address - Phone:718-407-4633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-25
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03432491Medicaid