Healthcare Provider Details

I. General information

NPI: 1699423954
Provider Name (Legal Business Name): MEDALLION HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2022
Last Update Date: 01/21/2026
Certification Date: 01/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

923 HADDONFIELD RD STE 300
CHERRY HILL NJ
08002-2752
US

IV. Provider business mailing address

923 HADDONFIELD RD STE 300
CHERRY HILL NJ
08002-2752
US

V. Phone/Fax

Practice location:
  • Phone: 267-688-3100
  • Fax: 215-689-4141
Mailing address:
  • Phone: 267-688-3100
  • Fax: 215-689-4141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: STEVEN JAMSHIDI
Title or Position: PRESIDENT
Credential:
Phone: 267-688-3100