Healthcare Provider Details
I. General information
NPI: 1457419400
Provider Name (Legal Business Name): US LIFE CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/04/2006
Last Update Date: 07/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3070 BRISTOL PIKE BUILDING 2, SUITE 133A
BENSALEM PA
19020-5364
US
IV. Provider business mailing address
3070 BRISTOL PIKE BUILDING 2, SUITE 133A
BENSALEM PA
19020-5364
US
V. Phone/Fax
- Phone: 215-639-8862
- Fax:
- Phone: 215-639-8862
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | 1000002485 |
| License Number State | PA |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
ROBIN
M
SERVILLAS
Title or Position: PRESIDENT
Credential:
Phone: 215-639-8862