Healthcare Provider Details

I. General information

NPI: 1477830305
Provider Name (Legal Business Name): MORAVIA HEALTH NETWORK, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2011
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 WALNUT ST STE 1900
PHILADELPHIA PA
19102
US

IV. Provider business mailing address

1500 WALNUT ST STE 1900
PHILADELPHIA PA
19102-3509
US

V. Phone/Fax

Practice location:
  • Phone: 215-717-8650
  • Fax: 215-717-7839
Mailing address:
  • Phone: 215-770-3333
  • Fax: 215-770-3000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number32093601
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. C. FRANK IGWE
Title or Position: PRESIDENT
Credential:
Phone: 215-770-3333