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NPI Code Detail

MEDICARE: KINDEST CARE HEALTHCARE LLC

MEDICARE: KINDEST CARE HEALTHCARE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN568664PA
2251E00000XHome Health Agency03230501PA

General Provider Information

NPI Number : 1053515445
Entity Type Code : Organization
Provider Name (Legal Business Name) : KINDEST CARE HEALTHCARE LLC
Provider Business Mailing Address
First Line : 8400 BUSTLETON AVE
Second Line : SUITE 2
City : PHILADELPHIA
State : PA
Zip : 19152-1918
Country : US
Telephone Number : 214-394-7679
Fax Number :
Provider Business Practice Location Address
First Line : 8400 BUSTLETON AVE
Second Line : SUITE 2
City : PHILADELPHIA
State : PA
Zip : 19152-1918
Country : US
Telephone Number : 215-639-4646
Fax Number :
Authorized Official
Title or Position : DIRECTOR OF NURSING SERVICES
Name : BOLA AMON
Credential : RN
Telephone Number : 214-394-7679
Provider Enumeration Date : 06/12/2007
Last Update Date : 03/13/2015

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Directions to “KINDEST CARE HEALTHCARE LLC ” Practice Location

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