MEDICARE: GENERALHEALTHCARE RESOURCES

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	313M00000X	Nursing Facility/Intermediate Care Facility	RN508556L	PA

General Provider Information

NPI Number	:	1508081753
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENERALHEALTHCARE RESOURCES

Provider Business Mailing Address
First Line	:	7612 DORCAS ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-3324
Country	:	US
Telephone Number	:	215-742-3874
Fax Number	:

Provider Business Practice Location Address
First Line	:	7612 DORCAS ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-3324
Country	:	US
Telephone Number	:	215-742-3874
Fax Number	:

Authorized Official
Title or Position	:	REGISTERED NURSE
Name	:	MRS. WANDA LADAWN NARCISSE
Credential	:	RN
Telephone Number	:	215-742-3874

Provider Enumeration Date	:	04/14/2007
Last Update Date	:	08/22/2020

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