Healthcare Provider Details

I. General information

NPI: 1922410182
Provider Name (Legal Business Name): OPTIMUM HOME CARE SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2014
Last Update Date: 06/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6567 N LAMBERT ST
PHILADELPHIA PA
19138-3112
US

IV. Provider business mailing address

6567 N LAMBERT ST
PHILADELPHIA PA
19138-3112
US

V. Phone/Fax

Practice location:
  • Phone: 267-240-1179
  • Fax: 267-368-6904
Mailing address:
  • Phone: 267-240-1179
  • Fax: 267-368-6904

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: CARLOS N SMITH
Title or Position: PRESIDENT
Credential: B.S. IN FINANCE
Phone: 267-240-1179