Healthcare Provider Details

I. General information

NPI: 1114184033
Provider Name (Legal Business Name): PROFESSIONAL HOME HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2008
Last Update Date: 05/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21309 BERLIN RD SUSSEX SUITES, UNIT 9
GEORGETOWN DE
19947-3185
US

IV. Provider business mailing address

620 FREEDOM BUSINESS CTR DR SUITE 105
KING OF PRUSSIA PA
19406-1330
US

V. Phone/Fax

Practice location:
  • Phone: 302-855-0310
  • Fax: 302-855-0840
Mailing address:
  • Phone: 610-205-2440
  • Fax: 610-205-2468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHHAS 028
License Number StateDE

VIII. Authorized Official

Name: MRS. CAROL L SMITH
Title or Position: CORP SR DIRECTOR BILLING
Credential:
Phone: 610-205-2440