Vivid Home Care Service Inc

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

License

R3696 Issued in MD

Legal business name

VIVID HOME CARE SERVICE INC

Doing business as

Vivid Home Care Service Agency

Practice address

1111 Country Terrace Road
Apartment E
Essex, MD 21221

Phone

(443) 677-3417

Fax

(443) 557-1492

NPI assigned

Apr 3, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Cynthia Ogadimma Egwim

Title

Administrator

Phone

(443) 677-3417

Specialties & licenses 2

Addresses

Other names 1

• VIVID HOME CARE SERVICE AGENCY Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428019200000",
    "number": "1225423411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 COUNTRY TERRACE RD",
            "address_2": "APARTMENT E",
            "city": "ESSEX",
            "state": "MD",
            "postal_code": "212214510",
            "telephone_number": "443-677-3417",
            "fax_number": "443-557-1492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 COUNTRY TERRACE ROAD",
            "address_2": "APARTMENT E",
            "city": "ESSEX",
            "state": "MD",
            "postal_code": "21221",
            "telephone_number": "443-677-3417",
            "fax_number": "443-557-1492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVID HOME CARE SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-03",
        "last_updated": "2015-04-03",
        "status": "A",
        "authorized_official_last_name": "EGWIM",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "OGADIMMA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "443-677-3417",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MD",
            "license": "R3696",
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "MD",
            "license": "R3696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VIVID HOME CARE SERVICE AGENCY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Nursing Care Agency in Essex, MD
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.