Healthcare Provider Details

I. General information

NPI: 1427567403
Provider Name (Legal Business Name): APEX HOMECARE ADVANTAGE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2017
Last Update Date: 09/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 MARCHWOOD RD STE 1-G
EXTON PA
19341-1836
US

IV. Provider business mailing address

33 DOWNING CIR
DOWNINGTOWN PA
19335-3375
US

V. Phone/Fax

Practice location:
  • Phone: 610-363-1485
  • Fax:
Mailing address:
  • Phone: 610-417-0913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number10763601
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier102652638
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 2
Identifier10763601
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerPENNSYLVANIA DEPARTMENT OF HEALTH LICENSE

VIII. Authorized Official

Name: GRIFFITH ROBERTS
Title or Position: TREASURER
Credential:
Phone: 610-417-0913