Healthcare Provider Details

I. General information

NPI: 1629995097
Provider Name (Legal Business Name): CENTRAL PENN HOME SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

447 N 3RD ST
COLUMBIA PA
17512-1139
US

IV. Provider business mailing address

447 N 3RD ST
COLUMBIA PA
17512-1139
US

V. Phone/Fax

Practice location:
  • Phone: 267-581-7918
  • Fax:
Mailing address:
  • Phone: 267-581-7918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. GEORGE THOMAS HICKS JR.
Title or Position: MANAGER
Credential:
Phone: 267-581-7918