Healthcare Provider Details
I. General information
NPI: 1134614282
Provider Name (Legal Business Name): DIGNIFY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/29/2018
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4619 STATE RD
DREXEL HILL PA
19026-4423
US
IV. Provider business mailing address
4619 STATE RD
DREXEL HILL PA
19026-4423
US
V. Phone/Fax
- Phone: 610-348-2769
- Fax:
- Phone: 610-348-2769
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 613449 |
| Identifier Type | OTHER |
| Identifier State | PA |
| Identifier Issuer | PA REGISTERED NURSE |
VIII. Authorized Official
Name: MS.
BERNADETTE
ORUMWENSE
Title or Position: ALT ADMINISTRATOR
Credential: REGISTERED NURSE
Phone: 610-348-2769