Healthcare Provider Details

I. General information

NPI: 1295478295
Provider Name (Legal Business Name): MONUMENTAL POST ACUTE CARE AT HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2022
Last Update Date: 07/31/2024
Certification Date: 07/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 FORD RD
PHILADELPHIA PA
19131-2833
US

IV. Provider business mailing address

4001 FORD RD
PHILADELPHIA PA
19131-2833
US

V. Phone/Fax

Practice location:
  • Phone: 215-877-4000
  • Fax:
Mailing address:
  • Phone: 215-877-5400
  • Fax: 215-877-4695

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: DAVID MILLER
Title or Position: CEO/MANAGING MEMBER
Credential:
Phone: 215-877-5400