Healthcare Provider Details

I. General information

NPI: 1558368589
Provider Name (Legal Business Name): BROTHERSTON HOMECARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2005
Last Update Date: 03/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1412 WELLS DR
BENSALEM PA
19020-4468
US

IV. Provider business mailing address

1412 WELLS DR
BENSALEM PA
19020-4468
US

V. Phone/Fax

Practice location:
  • Phone: 215-633-7300
  • Fax: 215-633-7304
Mailing address:
  • Phone: 215-633-7300
  • Fax: 215-633-7304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number6000003436
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number6000003436
License Number StatePA

VIII. Authorized Official

Name: MR. JAMES PATRICK FEENEY
Title or Position: PRESIDENT
Credential:
Phone: 215-633-7300