MEDICARE: MAEBILITY HOMECARE AGENCY 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1265221816
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAEBILITY HOMECARE AGENCY LLC

Provider Business Mailing Address
First Line	:	523 CONSTITUTION WAY
Second Line	:
City	:	AMBLER
State	:	PA
Zip	:	19002-1567
Country	:	US
Telephone Number	:	215-882-4197
Fax Number	:	215-882-4197

Provider Business Practice Location Address
First Line	:	40 W EVERGREEN AVE STE 101
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19118-3324
Country	:	US
Telephone Number	:	267-267-4860
Fax Number	:	267-267-4860

Authorized Official
Title or Position	:	OWNER
Name	:	DR. WALTER L KIMBLE JR.
Credential	:	PHD
Telephone Number	:	215-882-4197

Provider Enumeration Date	:	05/01/2025
Last Update Date	:	05/01/2025

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