Healthcare Provider Details

I. General information

NPI: 1285031898
Provider Name (Legal Business Name): MOYA HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2014
Last Update Date: 11/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

647 MALIN RD
NEWTOWN SQUARE PA
19073-2621
US

IV. Provider business mailing address

1512 LUCON RD
ORELAND PA
19075-2428
US

V. Phone/Fax

Practice location:
  • Phone: 215-836-1508
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MARY ANNE SUTER
Title or Position: COO
Credential:
Phone: 215-836-1508