MEDICARE: ELDER CARE CONNECT HOME HEALTH SERVICES, 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
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1104056084
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELDER CARE CONNECT HOME HEALTH SERVICES, LLC

Provider Business Mailing Address
First Line	:	942 JACKSON ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19148-3120
Country	:	US
Telephone Number	:	215-551-3101
Fax Number	:

Provider Business Practice Location Address
First Line	:	942 JACKSON ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19148-3120
Country	:	US
Telephone Number	:	215-551-3101
Fax Number	:

Authorized Official
Title or Position	:	NURSE
Name	:	MRS. MARCELINA AQUINO ANGUD
Credential	:
Telephone Number	:	215-551-3101

Provider Enumeration Date	:	07/25/2009
Last Update Date	:	07/25/2009

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