MEDICARE: DIMENSIONAL HEALTH CARE SERVICES, 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	77620501	PA

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	:	1588732788
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIMENSIONAL HEALTH CARE SERVICES, INC

Provider Business Mailing Address
First Line	:	4723 PINE ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19143-1831
Country	:	US
Telephone Number	:	215-528-6197
Fax Number	:	215-528-6301

Provider Business Practice Location Address
First Line	:	4723 PINE ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19143-1831
Country	:	US
Telephone Number	:	215-528-6197
Fax Number	:	215-528-6301

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. CORLISS HOBSON
Credential	:	CRNP
Telephone Number	:	215-528-6197

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	08/22/2020

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