Healthcare Provider Details

I. General information

NPI: 1497280788
Provider Name (Legal Business Name): ASHLAR HOME HEALTH AND HOSPICE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2017
Last Update Date: 07/24/2024
Certification Date: 07/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MASONIC DR
ELIZABETHTOWN PA
17022-2199
US

IV. Provider business mailing address

1 MASONIC DR
ELIZABETHTOWN PA
17022-2199
US

V. Phone/Fax

Practice location:
  • Phone: 717-367-1121
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number17211601
License Number StatePA

VIII. Authorized Official

Name: JUSTIN WOLGEMUTH
Title or Position: SENIOR VP OF OPERATIONS
Credential:
Phone: 717-367-1121