Healthcare Provider Details

I. General information

NPI: 1093940538
Provider Name (Legal Business Name): FAITH & HOPE BOUTIQUE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2009
Last Update Date: 05/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1915 GUERNSEY AVE
ABINGTON PA
19001-3701
US

IV. Provider business mailing address

1915 GUERNSEY AVE
ABINGTON PA
19001-3701
US

V. Phone/Fax

Practice location:
  • Phone: 215-885-1143
  • Fax: 215-277-5394
Mailing address:
  • Phone: 215-885-1143
  • Fax: 215-277-5394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: BONNIE SCALFARO
Title or Position: PRESIDENT
Credential:
Phone: 215-885-1143