Provider Demographics
NPI:1700063682
Name:COPIHUE CORP
Entity type:Organization
Organization Name:COPIHUE CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:PADUCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-384-6485
Mailing Address - Street 1:1345 JEFFERSON BLVD
Mailing Address - Street 2:SUITE 1W
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-2202
Mailing Address - Country:US
Mailing Address - Phone:401-384-6485
Mailing Address - Fax:401-384-6487
Practice Address - Street 1:1345 JEFFERSON BLVD
Practice Address - Street 2:SUITE 1W
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-2500
Practice Address - Country:US
Practice Address - Phone:401-384-6485
Practice Address - Fax:401-384-6487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIHCP02443251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health