MEDICARE: JILLIAN HATCH, LACTATION CONSULTANT

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	11211430	PA

General Provider Information

NPI Number	:	1992176705
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JILLIAN HATCH, LACTATION CONSULTANT

Provider Business Mailing Address
First Line	:	2245 CAMBRIDGE RD
Second Line	:
City	:	BROOMALL
State	:	PA
Zip	:	19008-2904
Country	:	US
Telephone Number	:	610-733-6789
Fax Number	:

Provider Business Practice Location Address
First Line	:	2245 CAMBRIDGE RD
Second Line	:
City	:	BROOMALL
State	:	PA
Zip	:	19008-2904
Country	:	US
Telephone Number	:	610-733-6789
Fax Number	:

Authorized Official
Title or Position	:	RNC-OB, IBCLC
Name	:	MRS. JILLIAN HATCH
Credential	:	RNC-OB, IBCLC
Telephone Number	:	610-733-6789

Provider Enumeration Date	:	10/19/2015
Last Update Date	:	10/19/2015

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