MEDICARE: TANYA'S HOME HEALTH SERVICE

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251J00000X	Nursing Care Agency
2	251K00000X	Public Health or Welfare Agency
3	253Z00000X	In Home Supportive Care Agency
4	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1093136202
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TANYA'S HOME HEALTH SERVICE

Provider Business Mailing Address
First Line	:	2331 WATKINS ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19145
Country	:	US
Telephone Number	:	215-397-0227
Fax Number	:

Provider Business Practice Location Address
First Line	:	2331 WATKINS ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19145-1828
Country	:	US
Telephone Number	:	215-397-0227
Fax Number	:

Authorized Official
Title or Position	:	CERTIFIED NURSING ASSISTANT
Name	:	DOMINIQUE BUSSEY
Credential	:
Telephone Number	:	215-397-0227

Provider Enumeration Date	:	12/16/2013
Last Update Date	:	01/23/2014

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