MEDICARE: GOLDEN PATH HOME CARE, INC.

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356872519
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDEN PATH HOME CARE, INC.

Provider Business Mailing Address
First Line	:	7577 N TEUTONIA AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53209-2041
Country	:	US
Telephone Number	:	414-236-5208
Fax Number	:	414-236-5648

Provider Business Practice Location Address
First Line	:	7577 N TEUTONIA AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53209-2041
Country	:	US
Telephone Number	:	414-236-5208
Fax Number	:	414-236-5648

Authorized Official
Title or Position	:	OWNER
Name	:	NICOSIA KING
Credential	:
Telephone Number	:	262-748-2596

Provider Enumeration Date	:	03/21/2017
Last Update Date	:	03/29/2021

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Directions to “GOLDEN PATH HOME CARE, INC. ” Practice Location

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