Healthcare Provider Details

I. General information

NPI: 1285744532
Provider Name (Legal Business Name): EFCC ACQUISITION CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 11/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1860 CHARTER LN SUITE 208
LANCASTER PA
17601-6730
US

IV. Provider business mailing address

33 WALT WHITMAN RD SUITE 302
HUNTINGTON STATION NY
11746-3640
US

V. Phone/Fax

Practice location:
  • Phone: 717-391-6363
  • Fax: 717-391-6367
Mailing address:
  • Phone: 631-423-6689
  • Fax: 631-427-5466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN188617L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN260438L
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number77440500
License Number StatePA

VIII. Authorized Official

Name: MR. STEPHEN STERNBACH
Title or Position: CEO
Credential:
Phone: 631-423-6689