Healthcare Provider Details

I. General information

NPI: 1962453118
Provider Name (Legal Business Name): CELTIC HOMECARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 12/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 SCHARBERRY LN
MARS PA
16046-2430
US

IV. Provider business mailing address

150 SCHARBERRY LN
MARS PA
16046-2430
US

V. Phone/Fax

Practice location:
  • Phone: 724-625-4280
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number397755
License Number StatePA

VII. Legacy identifiers

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

# 1
Identifier1373
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerBLUE CROSS
# 2
Identifier101557080-OOO1
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerMEDICAL ASSISTANCE
# 3
Identifier2587125
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerAETNA

VIII. Authorized Official

Name: WILLIAM D. GAMMIE
Title or Position: VICE PRESIDENT OF BUSINESS SERVICES
Credential:
Phone: 724-625-4280