Healthcare Provider Details

I. General information

NPI: 1669789392
Provider Name (Legal Business Name): PRN STAFFING HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2010
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

627 SWEDESFORD RD
MALVERN PA
19355-1530
US

IV. Provider business mailing address

627 SWEDESFORD RD
MALVERN PA
19355-1530
US

V. Phone/Fax

Practice location:
  • Phone: 610-738-4224
  • Fax: 484-320-8102
Mailing address:
  • Phone: 610-738-4224
  • Fax: 484-320-8102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number17753601
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: TARA MCALLISTER
Title or Position: ADMINISTRATOR
Credential:
Phone: 610-738-4224