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NPI Code Detail

MEDICARE: NEW COMPANION HOME CARE AGENCY LLC

MEDICARE: NEW COMPANION HOME CARE 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
1251E00000XHome Health Agency
2253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1609497072
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEW COMPANION HOME CARE AGENCY LLC
Provider Business Mailing Address
First Line : 1721 E MAYLAND ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19138-1113
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1721 E MAYLAND ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19138-1113
Country : US
Telephone Number : 484-375-3814
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DELLYSEA WASHINGTON
Credential :
Telephone Number : 484-375-3814
Provider Enumeration Date : 04/27/2020
Last Update Date : 04/27/2020

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Directions to “NEW COMPANION HOME CARE AGENCY LLC ” Practice Location

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