Healthcare Provider Details

I. General information

NPI: 1467446609
Provider Name (Legal Business Name): RX HOME CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2005
Last Update Date: 11/02/2020
Certification Date: 11/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 E BROAD ST STE 430
BETHLEHEM PA
18018-5963
US

IV. Provider business mailing address

1 E BROAD ST STE 430
BETHLEHEM PA
18018-5963
US

V. Phone/Fax

Practice location:
  • Phone: 610-868-1801
  • Fax: 610-954-9367
Mailing address:
  • Phone: 610-868-1801
  • Fax: 610-954-9367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number758705
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number758705
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number758705
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number758705
License Number StatePA

VIII. Authorized Official

Name: YITA MANDEL
Title or Position: PRESIDENT
Credential:
Phone: 845-641-6113