Healthcare Provider Details

I. General information

NPI: 1588660377
Provider Name (Legal Business Name): ERWINES HOME HEALTH AND HOSPICE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2005
Last Update Date: 05/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 PIERCE ST STE 208
KINGSTON PA
18704-5141
US

IV. Provider business mailing address

270 PIERCE ST STE 101
KINGSTON PA
18704-5141
US

V. Phone/Fax

Practice location:
  • Phone: 570-288-1013
  • Fax: 570-283-3722
Mailing address:
  • Phone: 570-288-1013
  • Fax: 570-288-6569

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number398010
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number391675
License Number StatePA

VIII. Authorized Official

Name: MARY J. ERWINE
Title or Position: PRESIDENT
Credential:
Phone: 570-288-1013